Engleza Kineto

ADINA RĂDULESCU

*

ENGLISH IN KINETOTHERAPY. A PRACTICAL ENGLISH HANDBOOK

Editura Fundaţiei România de Mâine 2004

6

ADINA RĂDULESCU

English in Kinetotherapy. A practical English handbook

7

CONTENTS CUVÂNT ÎNAINTE

UNIT 1 THE MAIN PARTS OF THE BODY IMPERATIVE SENTENCES USED IN RELAXATION TRAINING TECHNIQUES PREPOSITIONS

UNIT 2 THE SKELETAL SYSTEM INTERROGATIVE PRONOUNS AND ADVERBS USED BEFORE THE VERB TO BE ASKING QUESTIONS

UNIT 3 THE MUSCULAR SYSTEM ADJECTIVES – BASIC KNOWLEDGE DESCRIBING A CERTAIN MUSCLE

UNIT 4 EXAMINING THE PACIENT POLYSEMANTIC WORDS THERAPIST-PATIENT DISCOURSE – GREETINGS, IDENTIFICATION AND INTRODUCTORY DIALOGUES

UNIT 5 TYPES OF INJURIES PASSIVE MODAL CONSTRUCTIONS PRESENT TENSE SIMPLE AND PRESENT PERFECT THERAPIST-PATIENT DISCOURSE – PATIENT`S SYMPTOMS AND COMPLAINTS FORMAL AND INFORMAL MEDICAL TERMS

8

ADINA RĂDULESCU

UNIT 6 THERAPEUTIC EXERCISES WORD FORMATION – DERIVATION THERAPIST-PATIENT DISCOURSE – RECOMMENDING DIFFERENT THERAPEUTIC EXERCISES

UNIT 7 THERAPEUTIC PROCEDURES IN HANDLING THE PATIENT PASSIVE VERBAL CONSTRUCTIONS THERAPIST-PATIENT DISCOURSE – POSITIONING AND HANDLING THE PATIENT

UNIT 8 MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS PRONOUNCING TONGUE-TWISTERS DESCRIBING SYMPTOMS AND RECOMMENDING THERAPEUTIC EXERCISES

UNIT 9 POSTURAL PROBLEMS CONDITIONAL CLAUSES THERAPIST-PATIENT DISCOURSE – IMPROVING COMMUNICATION

UNIT 10 REVISION EXERCISES

BIBLIOGRAPHY

CUVÂNT ÎNAINTE

English in Kinetotherapy. A practical English handbook

9

Specificul studierii limbilor străine în cadru universitar este reprezentat de trecerea de la studierea limbii străine la modul general la aprofundarea ei pe diverse domenii de specialitate. În funcţie de specializarea pentru care studenţii optează, ei vor studia, în cazul nostru, engleza economică, juridică, tehnică, medicală etc. Studiul limbilor străine aplicate pe un anumit domeniu de specialitate – în cazul nostru fiind vorba de engleza în kinetoterapie, o ramură a englezei medicale – presupune din partea studenţilor un nivel mediu de cunoştiinţe de limba engleză, stăpânirea unor tehnici de muncă individuală şi, de asemenea, a unui nivel mediu de cunoştiinţe generale pe domeniul respectiv de specialitate. Manualul de faţă se adresează studenţilor secţiei de Kinetoterapie, din cadrul Facultăţii de Educaţie Fizică şi Sport a Universităţii Spiru Haret Bucureşti, atât anului I cât şi anului II de studiu. El răspunde unei nevoi reale – aceea de a avea un instrument practic de lucru pentru desfăşurarea activităţii de seminar. Conştientizarea avantajelor pe care le presupune stăpânirea unui limbaj de specialitate într-o limbă străină, dintre care amintim: posibilitatea consultării unei bibliografii de specialitate în limba respectivă, participarea studenţilor la conferinţe internaţionale, publicarea unor materiale în revistele de specialitate şi, poate cel mai important, posibilitatea de a lucra într-o clinică sau cabinet de profil cu personal şi clienţi străini fie în România fie peste hotare – a constituit motivaţia principală pentru menţinerea interesului studenţilor faţă de această disciplină de studiu şi pentru obţinerea unui certificat de competenţă lingvistică pe specialitatea engleză medicală, eliberat în cadrul Centrului de Limbi Străine al Universităţii Spiru Haret.

10

ADINA RĂDULESCU

Manualul este structurat pe 10 capitole (Units), axându-se pe trei componente principale: 1) un corpus de texte de specialitate, care-şi asociază diverse exerciţii de vocabular, traduceri de text şi exerciţii de redare selectivă a informaţiei prezentate; 2) o selecţie a unor probleme de gramatică a limbii engleze, efectuată în funcţie de criteriul frecvenţei anumitor structuri gramaticale în limbajul medical şi 3) un set de „discursuri” kinetoterapeut-pacient, axate pe tematica fiecărui capitol, având ca scop familiarizarea studenţilor cu utilizarea unui limbaj oral, informal, care completează limbajul formal în care sunt redate textele de specialitate. Selectarea acestor texte din diverse materiale – atlase de anatomie, cursuri de kinetoterapie, etc a avut ca intenţie creearea unui cadru „profesionist” de lucru, precum şi stimularea interesului studenţilor pentru consultarea unor materiale de specialitate în limba engleză. Şi, nu în ultimul rând, exerciţiile de la fiecare sfârşit de Unit – “create your own dialogues”, “consider yourself as a kinetotherapist” etc. testează capacitatea studenţilor de a se exprima liber şi firesc în limbajul de specialitate asimilat, într-un context socioprofesional artificial creat în sala de seminar, prin ceea ce în metodica limbii engleze se numeşte “Role playing”. Cu speranţa şi dorinţa că acest manual va răspunde nevoii practice a studenţilor de a aprofunda limba engleză pentru o viitoare practică kinetoterapeutică, constituind în acelaşi timp un stimulent pentru o perfecţionare permanentă, prin consultarea unei bibliografii actualizate în limba engleză, închei prin a le mulţumi studenţilor din primele generaţii cu care am lucrat pentru ajutorul pe care mi l-au acordat, prin simpla lor participare activă la seminariile de limba engleză, în conturarea suportului teoretic şi practic al acestui manual.

English in Kinetotherapy. A practical English handbook

11

Autoarea

UNIT I THE MAIN PARTS OF THE BODY IMPERATIVE SENTENCES USED TRAINING TECHNIQUES PREPOSITIONS

IN

RELAXATION

1. Read the following texts containing relaxation techniques and write down the new words: “Trainer’s introduction: ‘This relaxation procedure is one that has been practised for many years now. It has been studied by researchers and found to be effective. You will feel very relaxed and calm as a result. It is not the same as hypnosis and you will not lose consciousness at any point.’ The procedures: ‘Make yourself as comfortable as you can… become aware of the surface underneath you… let your body settle into it… notice how it supports you… notice the points of contact between you and the floor: your head… shoulders… spine… ribs… hips… heels… elbows… forearms and hands… feel your body sinking into the surface you are lying on… feel your body getting heavier as the tension ebbs away… feel at peace…. Take one good breath and as you let it out, feel it carrying all your tensions away… then let your breathing settle into a gentle rhythm…’ ‘As you lie or sit, reflect on the idea that you are going to give the next half-hour to yourself. No telephone can ring for you; no doorbell disturb you; no one will call your name. You may hear sounds around you: voices, horns, sirens, bangs and revs… think of them as being outside your world. With these thoughts in mind, draw an imaginary circle around yourself, about three feet from the centre. Create an imaginary bubble… think of the interior as your space… your own private space. Feel how safe it is… safe to get in touch with yourself. Turn your thoughts inward.’

12

ADINA RĂDULESCU

Trainer’s termination of the procedure: ‘I am going to bring this relaxation sesssion to an end… I’d like you gradually to become aware of the room… feel the floor/chair underneath you … open your eyes… give your limbs a few gentle stretches… have the feeling that you are alert and ready to carry on with your life…’ ‘With your eyes open, raise your eyebrows… feel the tension… and release the tension… frown… feel the tension… and release it… shut your eyes tightly… feel the tension… and let it go… with your eyes still closed, spend a few minutes releasing tension in this part of your face… Close the jaws firmly, noticing the sensations you get from the action… hold it… and… discontinue… let your jaw drop… feel the tension leaving you… and continuing to leave you… then repeat the action…. Next, bare your teeth… feel the tension in the cheeks… hold it for a few seconds… and release the tension…. Make a tight ‘O’ with your lips… hold it, while you register tension in the lips… and cancel the action…. Press your tongue against your teeth… feel the pressure and release it… Now pull the tongue back towards the throat. Feel the muscles drawing it back and note the sensations you get from this action… and… release it… ” (R. A. Payne – Relaxation Techniques) 2. Read the text again, select the words that designate: a) parts of the body, b)verbal constructions expressing commands and c) prepositions or other words indicating direction and place them in three different columns. 3. Using the vocabulary practice below write the Romanian equivalents for the terms indicating parts of the body. ♣ VOCABULARY PRACTICE 4. Pronounce and learn the names of the main parts of the human body. For some notions two alternative terms have been provided:

English in Kinetotherapy. A practical English handbook

13

The head: - eyes, eyelids (pleoape), eyelashes (gene), eyebrows (sprâncene); - nose, nostrils (nări); - ears, ear lobe; - mouth, lips (buze), gum (gingie), tooth - teeth, tongue (limbă), jaw (falcă), upper jaw /maxilla (maxilar), under jaw (mandibulă); - forehead (frunte), cheek (obraz), cheek bone (os maxilar), chin (bărbie), dimple (gropiţă în obraz), dimple in the chin /fossette (gropiţă în bărbie). The neck: -

throat; Adam’s apple/thyroid cartilage; hollow of the throat (scobitura gâtului); nape of the neck (ceafa).

The body: - shoulder, shoulder blade/scapula (omoplat); - limb (membru), arm/upper limb (braţ), armpit/axilla (subsuoară), forearm (antebraţ), hand, elbow (cot), crook of the arm (îndoitura braţului), palm, wrist/carpus (încheietura mâinii), fist (pumn), fingers – thumb (degetul mare), forefinger (deget arătător), middle finger, ring finger (deget inelar), little finger, finger tip (vârful degetului), finger pad (perniţa degetului), fingernail (unghie), knuckle (articulaţia degetului); - biceps, thorax/chest (torace), breast (piept), nipple (mamelon), abdomen, stomach, waist (talie), navel/umbilicus (buric), bottom (şezut), buttocks (fese); - hip (şold), leg, thigh (coapsă), calf

14

ADINA RĂDULESCU

(gambă), shin/cannon bone (fluierul piciorului, tibia), knee (genunchi), knee cap (rotulă), ankle (gleznă), instep (scobitura gleznei), sole (talpă), heel/calcaneus (călcâi), toes (degete de la picioare). 5. Choose the right word that best completes the sentence: 1. I can’t move my left hand; I have problems with my ………... a) fingers b) armpit c) wrist d) fists 2. It is not polite to talk to somebody when you have your ………. in your pockets. a) fingers b) hands c) palms d) arms 3. He has had this nasty habit of biting his ………. ever since he was a kid. a) tongue b) toes c) fingers d) nails 4. This old lady can’t hear you very well; she has got an ……… infection. a) ear b) throat c) tooth d) eye 5. He fell and hurt his ……… really bad, as he was not wearing his knee-pads when roller skating. a) ankles b) legs c) knees d) toes 6. The underside both of a foot and a shoe is called a ………….. a) heel b) sole c) shin d) toe 7. I ate an icecream yesterday and now I have a sore ……………. a) neck b) eye c) jaw d) throat 8. You should not drink so much coffee on an empty …………….. a) stomach b) waist c) abdomen d) throat 9. Nobody is perfect and carelessness is his Achilles’………... a) toe b) arm c) heel d) head 10. He is walking on the tips of his ………… so as not to awake the baby. a) feet b) toes c) fingers d) sole

English in Kinetotherapy. A practical English handbook

6. Match up the following words with their definitions: 1. wrist 2. forehead 3. hip 4. tongue 5. calf 6. armpit 7. nostril 8. thigh 9. fingernail 10. heel 11. abdomen 12. biceps

a. the thick, fleshy part of the back of the leg, between the ankle and the knee b. large muscle at the front of the upper arm, which bends the elbow c. the small depression beneath the arm where it joins the shoulder d. a thin, horny, translucent plate covering part of the dorsal surface of the end joint of each finger e. the part of the face between the natural hairline and the eyes; formed skeletally by the frontal bone of the skull f. part on either side of the body below the waist where the bone of a person’s leg is joined to the trunk g. the joint between the forearm and the hand h. the back part of the human foot from the instep to the lower part of the ankle i. part of the body below de chest and diaphragm, containing the stomach, bowels and digestive organs j. organ of taste that aids the mastication and swallowing of food. k. either of the two external openings of the nose l. part of the human leg between the knee and the hip

♣ VOCABULARY PRACTICE

15

16

ADINA RĂDULESCU

Here is a list of the most commonly used prepositions of place and position: above = deasupra, de deasupra, mai sus de across/along = de-a lungul, transversal around/round = de jur împrejurul below = dedesubt, sub (fără a indica contact cu suprafaţa superioară) beneath/underneath = dedesubt, sub (indicând existenţa unei suprafeţe superioare de protecţie, separare) between = între (două obiecte) behind = în spatele, înapoia in front of = în faţa in = în, în interiorul into = în, înspre interior (indicând pătrunderea, străbaterea spaţiului) on = pe, deasupra onto = pe, deasupra (indicând mişcare pentru atingerea poziţiei) over = peste, deasupra through = prin, printre under = dedesubt, sub (indicând contact cu suprafaţa superioară) Other words indicating movement and direction: -WARDS class (wards = spre, către, indicând direcţia) Backward (s) = înapoi, invers, pe spate Downward (s) = descendent, spre partea inferioară Forward (s) = înainte, în faţă Inward (s) = înăuntru, către interior Leftward (s) = către stânga, dinspre stânga Outward (s) = către/spre exterior, în afară Towards = spre, către, în direcţia Upright = drept, vertical

English in Kinetotherapy. A practical English handbook

17

Upward (s) = ascendent, spre partea superioară Sideways = lateral, oblic, într-o parte ►◄Pair work 7. Read the following commands to your deskmate and ask him/her to follow your indications and practise the exercises. Then, change activities: • Place your hands around your ankles. • Rest your elbows on your thighs. • Place your fingertips on your shoulder. • Bend your body sideways and give it a good stretch. • Lift your arms above your head. • Spread your arms sideways and lower them to your sides. • Clasp both hands behind your head. • Arch your body backwards. • Stretch your arms upwards. • Bend your knees forwards. • Hold your head forward and up. • Raise your arms above your head and turn the palms towards the ceiling. • Lean your forearms vertically on the wall. With your heels on the ground and your knees straight, let your hips sink forwards. 8. Read the following sentences and translate them into Romanian: • Without moving your head, turn your eyes upwards behind your closed lids. • Roll your eyes in a clockwise circle… Now notice the sensations of tension…. Pause… Roll them now in an anticlockwise direction. • Place your palm downwards on a surface (table, chair arm or thigh); press your fingertips into the surface, drawing them towards your palm so that your hand gradually takes on the shape of a spider… Hold the position, feel the tension in the hand and then let the tension

18

ADINA RĂDULESCU

go and relax the muscles. • Keeping your toes firmly in contact with the floor, raise your heels up in the air… Now feel the tension in your calf muscles… Relax… drop your heels to the ground and notice the relief, the comfort, the warm tingling sensation in your calves. 9. Create your own relaxation techniques; write down five examples of such exercises and then read them to your deskmates. 10. Translate into English, using the new words: 1. Plasaţi-vă ambele mâini pe umeri. Rotiţi-vă trunchiul alternativ la stânga apoi la dreapta. 2. Staţi în poziţie depărtată, cu mâinile pe lângă corp. Ridicaţi mâna dreaptă şi îndoiţi corpul spre stânga. Reveniţi în poziţia iniţială. Apoi ridicaţi mâna stângă şi îndoiţi corpul spre dreapta. Repetaţi mişcarea de cinci ori. 3. Îndoiţi-vă uşor trunchiul în faţă. Atingeţi-vă genunchii, apoi gambele, apoi gleznele şi dacă puteţi chiar şi degetele de la picioare. 4.Stând pe un scaun, plasaţi-vă ambele coate pe coapse, întindeţi-vă antebraţele şi mişcaţi-vă degetele. 5. Închideţi ochii, ridicaţi mâinile deasupra capului şi arcuiţi-vă uşor trunchiul pe spate. Staţi în poziţie 10 secunde şi apoi reveniţi în poziţia iniţială. 6. Plasaţi-vă ambele mâini pe şolduri. Îndoiţi-vă uşor genunchii şi apoi rotiţi-vă corpul la stânga şi la dreapta. Observaţi ce simţiţi la articulaţiile şoldului. 7. Întindeţi-vă braţele lateral. Apoi îndoiţi-le din coate spre în faţă, la nivelul umărului. Repetaţi mişcarea de câte ori doriţi. 8. Staţi ghemuiţi pe vârfurile picioarelor, cu capul aplecat şi cu mâinile atârnând pe genunchi. Simţiţi cum vi se relaxează muşchii gâtului. Menţineţi poziţia cât

English in Kinetotherapy. A practical English handbook

19

doriţi. 9. Staţi cu picioarele depărtate şi cu mâinile pe şold. Înclinaţi-vă spre dreapta, ridicând piciorul stâng. Menţineţi poziţia pentru 5 secunde. Apoi repetaţi în direcţia opusă. 10. Staţi cu picioarele depărtate şi cu mâinile întinse lateral şi cu pumnii strânşi. Rotiţi-vă simultan braţele, trasând un cerc mic în aer. Încercaţi rotirea braţelor în ambele direcţii. Observaţi ce se întâmplă cu muşchii braţelor şi pieptului.

UNIT 2 THE SKELETAL SYSTEM INTERROGATIVE PRONOUNS BEFORE THE VERB TO BE ASKING QUESTIONS

AND

ADVERBS

1. Read the following texts and write down the new words:

USED

20

ADINA RĂDULESCU

“The function of the bones is to form a hard skeleton for the softer materials of the body, to enclose and protect some of the most important vital organs. Bone development takes place at a very early period. In embryonic life, the parts destined to become bones consist of a congeries of cells which constitutes the simplest form of cartilage. This temporary cartilage is an exact miniature of the bone which in due course is to take its place. The process of ossification is slow and not completed until adult life. The next step is the ossification of the intercellular substance and of the cells composing the cartilage. The period of ossification varies much in different bones. It commences first in the clavicle, in which the primitive point appears during the fifth week; next in the lower jaw. The ribs also, and the long bones of the limbs, appear soon after. For a long period after birth, a thin layer of unossified cartilage remains between the diaphysis and epiphyses, until their growth is finally completed.” (Henry Gray – Gray`s Anatomy. Descriptive and Surgical) “Almost all the elements of the joints of adults are also present in the joints of the newborn. The most active factor determining the formation of a joint after birth are the muscles which exert an action on the given joint, i.e. the work of a joint. The development of bone articulations is directly dependent on the formation of the bony and connective-tissue structures and muscular tissue. All the elements encountered in the joints of the newborn continue their formation and acquire the geometrical shapes of the articular surfaces characteristic of each joint of an adult. ” (R.D. Sinelnikov – Atlas of Human Anatomy)

♣ VOCABULARY PRACTICE

2. Pronounce and learn the names of the main parts of the skeletal system. Add more terms to the list:

English in Kinetotherapy. A practical English handbook

21

The skeletal system: - skull = craniu - spine/spinal column/backbone = coloana vertebrală - vertebra, -ae /bony ring = vertebră - spinal cord /marrow = măduva spinării - the cervical, dorsal, lumbar, sacral and coccygeal sections of the spine = secţiunile cervicale, dorsale, lombare şi coccigiene ale coloanei vertebrale - rib = coastă - cartilage = cartilaj - sternum /breastbone = stern - clavicle /collarbone = claviculă - thoracic cage = cuşcă toracică - shoulder girdle = centură scapulară - scapula/ shoulder blade = omoplat, scapulă - pelvis = pelvis - pubis = pubis - sacrum = os sacral - coccyx = coccis - articulation /joint = articulaţie - fibrous joint = articulaţie fibroasă - synovial joint = articulaţie sinovială - ossification = osificare - ligament = ligament - hip joint = articulaţia şoldului - knee joint = articulaţia genunchiului - ankle joint = articulaţia gleznei 3. Complete the following sentences using the nouns in the box. The first one has been done for you as an example:

22

sternum scapula tibia

ADINA RĂDULESCU

coccyx phalanges metacarpus

carpus cranium femur

calcaneus joint vertebrae

1. The spine is a flexuous column, formed of a series of bones called _vertebrae_. 2. The ____________ is composed of eight bones: the occipital, two parietal, frontal, two temporal, sphenoid, and ethmoid. 3. The ____________ is a long, flat vertical bone, situated in front of the thorax to which are attached the collarbone and the first seven parts of ribs. 4. The ____________ is the longest, thickest and heaviest bone in the skeleton, articulating with the pelvis above and the knee below. 5. The ____________ is the inner and thicker of the two bones of the human leg, between the knee and ankle. 6. The ____________ is a small triangular bone at the end of the spinal column, articulating by its base with the apex of the sacrum. 7. The ____________ is a large, flat bone, triangular in shape which forms the back part of each shoulder. 8. The hand is subdivided into three segments: the __________ or wrist, the ____________ or palm and the ____________ or fingers. 9. The ______________ or heel bone is the largest tarsal bone, irregularly cuboidal in form and situated at the lower back part of the foot. 10. The structures which enter the formation of a ___________ are: bone, cartilage, fibro-cartilage, ligament and synovial membrane. 4. Match up the following words with their definitions: 1. breastbone 2. ligament 3. skull

a. Rings placed one above the other which form a single column, the spinal column b. Triangular bone that forms the back of the pelvis c. Twelve pairs of curved bones extending

English in Kinetotherapy. A practical English handbook

4. vertebrae 5. clavicle 6. spine 7. pelvis 8. sacrum 9. cartilage 10. ribs

23

from the backbone round the chest d. Narrow, bony and curved column – as a cable for the spinal cord e. Basin-shaped framework of bones at the lower end of the body f. Tough white flexible tissue attached to bones and joints g. Though, flexible tissue that connects bones and holds organs in position h. Thin, flat, vertical bone in the chest, between the ribs i. Bone joining the breastbone and the shoulder blade j. Bony framework of the head under the skin

■ GRAMMAR INTERROGATIVE PRONOUNS BEFORE THE VERB TO BE

AND

ADVERBS

USED

When forming interrogative sentences with the verb TO BE the rule to be remember is to place the words in the following order: WHAT WHICH WHERE + is (sg.) / are (pl.) – present + object WHY + was (sg.) / were (pl.) – past + object HOW HOW MANY WHAT – is used to ask somebody to specify one or more things,

places, people, etc from an indefinite number: What are the main causes of muscular weakness? What is the shape of the spinal column? WHICH - is used to ask somebody to specify one or more things, people, etc from a limited number:

24

ADINA RĂDULESCU

Which is the best treatment in this situation? Which is the shortest and the most curved of all the ribs? WHY - means for what reason or purpose: Why is physical therapy better than surgery in my case? WHERE – means in or to what place or position: Where is the sternum situated? HOW – means in what way or manner: How is the sternum described in terms of shape, position, structure and development? HOW MANY – is used to inquire about the number of things: How many phalanges are for each finger, except the thumb? 5. Ask questions for the underlined phrases using the interrogative words what, which, where, why, how, how many and the verb to be. The first two have been done for you as examples: 1. There are twelve ribs on each side of the thoracic part of the spinal column. How many ribs are on each side of the thoracic part of the spinal column? 2. The foot consists of three divisions: the tarsus, metatarsus and phalanges. Which are the three divisions of the foot? 3. The leg consists of three bones: the patella (knee cap), placed in front of the knee, the tibia and fibula. ________________________________________________________ __? 4. The patella is a small, flat, triangular bone situated at the anterior part of the knee joint. ________________________________________________________ __?

English in Kinetotherapy. A practical English handbook

25

5. The scapula is situated between the first and seventh ribs. ________________________________________________________ __? 6. The sternum has the shape of an ancient sword, consisting of three parts. ________________________________________________________ __? 7. That form of cartilage which enters into the formation of the joints is called articular cartilage. ________________________________________________________ __? 8. The ligament is pliant and flexible, so as to allow perfect freedom of movement but strong, tough and inextensible, so as not to yield under a severely applied force. (ask three questions)

________________________________________________________ _? 9. There are 206 distinct bones in the entire skeleton of an adult. ________________________________________________________ _? 10. The superior extremity is the largest part of the humerus. ________________________________________________________ _?

26

ADINA RĂDULESCU

6. Read the following extracts and translate them into Romanian: “Most bones of a human adult consist of a bony and cartilaginous framework, as a result of which a bony part and a cartilaginous part are distinguished in the skeletal system. The bony part makes up most of the bone. The articular cartilages, the epiphyseal cartilages and the costal cartilages form the cartilaginous part of the skeletal system. The long bones (humerus, clavicle, femur, phalanges, etc.) have a middle part, the diaphysis, and two end parts, the epiphyses. The epiphysis located closer to the axial skeleton is called the proximal epiphysis, while the epiphysis of the same bone but situated further from the axial skeleton is called the distal epiphysis. The wider parts of long bones between the diaphysis and the epiphysis are known as metaphysis. Their boundaries are visible only in the bones of children and adolescents when a cartilaginous layer, the epiphyseal cartilage still remains between the diaphysis and epiphyses. The red marrow possesses high functional activity and is capable of forming blood cells of the myeloid series. With the development and growth of the organism, the red marrow is gradually replaced by the yellow marrow. The yellow marrow is less active and plays a reserve role, but under certain conditions it may be activated.” (R.D. Sinelnikov – Atlas of Human Anatomy) 7. Translate the following questions into English, using the new vocabulary. Providing an answer to these questions will also test your anatomy knowledge: 1. Care este ştiinţa care se ocupă cu studiul oaselor? 2. Care sunt principalele tipuri de oase? 3. Care sunt părţile constituente ale unei articulaţii? 4. Care sunt cauzele care determină traumatismele şi

English in Kinetotherapy. A practical English handbook

27

fracturile coloanei vertebrale? 5. Din câte oase este format craniul şi care sunt acestea? 6. Care articulaţie este cel mai frecvent afectată în fracturi? 7. Câte vertebre are coloana lombară? Dar coloana toracală? 8. Unde este plasat acromionul? 9. Cum este descris sternul în atlasul de anatomie? 10. De ce este intervenţia chirurgicală mai potrivită în acest caz decât fiziokinetoterapia sau balnoeterapia? ►◄ Pair work 8. Question-answer exercise: Using your anatomy courses notes, ask your deskmate questions about the skeletal system.

UNIT 3 THE MUSCULAR SYSTEM

28

ADINA RĂDULESCU

ADJECTIVES – BASIC KNOWLEDGE DESCRIBING A CERTAIN MUSCLE 1. Read the following texts about the muscular system and write down the new words: “There are more than 600 skeletal muscles in the human body and their total mass accounts for up to 28-35 per cent of the body mass in females, up to 40-45 per cent in males, and up to 45-55 per cent in athlets. Up to 50 per cent of the total weight of the skeletal muscles fall to the share of the muscles of the lower limbs, up to 30 per cent to those of the upper limbs, and up to 20 per cent to the share of the muscles of the head and trunk. Each muscle has a developed network of blood vessels. The contraction of a muscle promotes rapid flow of blood, i.e. the muscle is a peculiar ‘pump’ which forces the blood forward. Under conditions of reduced motor activity (hypokinesia) in an active mode of life or when prolongued bed-rest is necessary, this function of the skeletal muscles is excluded as a result of which the blood flows slower, metabolic processes are reduced and stasis occurs. In contrast, under conditions of motor activity the reserve capillaries open, new capillaries form, and nutrition of the skeletal muscles improves.” (R. D. Sinelnikov – Atlas of Human Anatomy) “All elements of the musculoskeletal system are in dynamic equilibrum, continually changing shape, structure and function, in response to loading and mechanical demands. The system is vulnerable to trauma, peculiarly susceptible to local and systemic inflamatory disorders. Acute inflammation or tissue damage often becomes chronic, perhaps because of continuous movement and mechanical stresses. Musculoskeletal disorders are major worldwide causes of chronic pain and severe physical handicap, particularly as population becomes older, generally fitter, and more health conscious.”

English in Kinetotherapy. A practical English handbook

29

(The Merk Manual of Diagnosis and Therapy) “Muscles vary considerably in their form. In the limbs, they are of considerable length, especially the more superficial ones, the deep ones being generally broad; they surround the bones and form an important protection to the various joints. In the trunk, they are broad, flattened and expanded, forming the parietes of the cavities which they enclose.” (Henry Gray – Gray’s Anatomy. Descriptive and Surgical) ♣ VOCABULARY PRACTICE

2. Pronounce and learn the main terms and collocations related to the muscular system. Add more terms to the list: - muscle = muşchi - skeletal muscle = muschi scheletic - tendon = tendon - muscular tissue = ţesut muscular - blood vessels = vase sanguine - nerves = nervi - fibers = fibre - fascia = fascie - diaphragm = diafragmă - musculature = musculatură - muscle bulk = masă musculară - muscular contraction /cramp = contracţie musculară - muscular endurance = rezistenţă musculară - muscle fatigue = oboseală/ extenuare musculară - muscular hypertrophy = hipertrofie musculară - muscle tone = tonus muscular - hypotonic muscles = muşchi hipotonici

ADINA RĂDULESCU

30

-

hypertonic muscles = muşchi hipertonici muscle rigidity = rigiditate musculară muscle spasm = spasm muscular spasticity = spasticitate muscle sprain = luxaţie muscle strain = întindere musculară muscle strength = forţă musculară muscular tension = tensiune musculară muscular weakness = slăbire musculară

3. Match the half-sentences in column A with their corresponding half-sentences in column B to form correct and complete sentences: A B 1. Muscle bulk…. a. … a progressive loss of muscle strength in a variety of muscle groups. 2.Muscle-setting exercise…. b. …very firm, may be spastic or rigid and resists sideways movements. 3. Muscular dystrophy is a c. … a muscle sprain or degenerative muscle strain, arthritis, a tumor or disorder characterized by …. a ruptured cartilage disk between vertebrae. 4. Electromyography (EMG) d. … very soft, weak and flabby and is easily moved is a techique… laterally. 5. A hypertonic muscle feels e. … gives an indication of the state of the … musculature. 6. If you have observed f…. an evaluation of the condition and functioning muscle weakness, … of the muscles, joints and bones of the body.

English in Kinetotherapy. A practical English handbook

7. Involuntary movements g. … is a method of contracting and relaxing a and tremors … skeletal muscle without moving that part of the body. 8. Low back pain at the base h. … that records changes of the spine can be caused in the electrical potential during muscle by … contractions. 9. Musculoskeletal sysytem i. … are signs of some neurological disorders. assessment is … 10. A hypotonic muscle feels j. …then a detailed test will be necessary for each … muscle. 4. Match up the following words with their definitions: 1. tendon

2. fasciae 3. blood vessels 4. fibres 5. nerve 6. capillaries

a. Fibre or bundle of fibres carrying impulses of sensation or of movement between the brain and all parts of the body b. Large muscle at the front of the upper arm, which bends the elbow c.Wall of muscle, between the chest and the abdomen, that helps to control breathing d. Very narrow blood vessels connecting arteries and veins in the body e. Fibrous membranes which form linings for body cavities and cover muscles and organs f. Strong band or cord of tissue that joins muscle to bone

31

32

7. muscular dystrophy 8. diaphragm 9. biceps

10. pectoral muscle

ADINA RĂDULESCU

g. Slender threads of which many human, animal or plant tissues are formed h. Tubes (arteries, veins or capillaries) through which blood flows in the body i. Broad, thick, triangular muscle, situated at the upper and anterior part of the chest that draws the arm towards the body j. Long-lasting illness in which the muscles become gradually weaker

■ GRAMMAR ADJECTIVES – BASIC KNOWLEDGE Participial and qualificative adjectives Considering the frequency of certain types of adjectives in medical language we shall deal only with participial and qualificative adjectives. Participial adjectives are participial forms used as adjectives: - Present Participle forms: short infinitive + -ING: increasing, relaxing, growing - Past Participle forms: short infinitive + -ED (for regular verbs): reduced, flattened, expanded or the third form of irregular verbs: cut, hidden, frozen. Example: This relaxing atmosphere and these stimulating exercises will have a pronounced effect on your back muscles. Qualificative adjectives include all types of adjectives denoting quality, size, shape, colour, origin, age and general descriptions of objects (parts of the body, diseases, symptoms etc) and people: Example:

English in Kinetotherapy. A practical English handbook

33

The first piece of the sternum has a triangular form, broad and thick above and narrowed below. Both participial and qualificative adjectives can either precede the noun, having the same form for all genders, both singular and plural (attributive position) or follow the noun, having the function of predicatives for copulative verbs such as: be, become, look, seem, turn etc: Example: Moderate exercises have a therapeutic effect on muscles.(attributive position) The muscles become resistant to fatigue and the patients no longer look exhausted at the end of the session.(predicative position) Degrees of comparison According to the way they form their degrees of comparison adjectives fall into three categories: 1) monosyllabic (or short) adjectives and bisyllabic adjectives ending in -er, -y and –ly which form their corresponding degrees of comparison by adding –er and –est (synthetic comparison): thick – thicker – the thickest thin –thinner – the thinnest 2) long adjectives – bisyllabic (ending in -ful and -re), trisyllabic or plurisyllabic which form their degrees of comparison by periphrastic means: more and (the) most (analytic comparison): extensive – more extensive – the most extensive 3) adjectives with irregular degrees of comparison: good – better – the best bad – worse – the worst little – less – the least many/much – more – the most old – older – the oldest (of people and objects)

34

ADINA RĂDULESCU

old – elder – the eldest (of people) far – farther – the farthest (of space) far – further – the furtest (of time) Constructions with comparisons: The use of adjectives at different degrees of comparison requires the use of certain patterns. For instance, adjectives at superlative will be associated with perfect tenses: This is the most distressing pain I have ever had. The comparative requires the specification of the second term of comparison, which can be either a word or a sentence: I am not as useless as my blind brother /as you think I am. The injury was more severe than we thought. Gradual increase or decrease is expressed by two comparatives joined by and: As your breathing becomes slower and slower you are feeling more and more relaxed. Sometimes the comparatives are placed at the beginning of the sentences: The sooner you practise the exercise, the better you will feel. The larger the muscle, the greater its strength. 5. Reread the texts about the muscular system and extract all the adjectives. Group them according to their attributive or predicative position. For derivational adjectives indicate the noun that they derive from and their suffix or prefix as in the following examples: systemic = system (noun) + -ic (suffix) skeletal = skelet (noun) + -al (suffix) 6. Form derivational adjectives from the following nouns and verbs, choosing the appropriate suffixes in the box. Sometimes more than one suffix can be attached to part of the words:

English in Kinetotherapy. A practical English handbook

-al -ish -ible

-ic -ive -ed

-ous -ful -ing

35

-less -able

Example: Stern + -al = sternal thorax sphere muscle abdomen stomach anomaly fibre fever cure help

comfort to identify to contract access memory to connect to digest health infection pain

7. Translate the following sentenses into English, using the new vocabulary and grammar notes of this unit: 1. Ce cauzează hipertrofia musculară? 2. Cu cât rezistenţa musculară este mai mare cu atât va fi mai mare numărul de contracţii musculare. 3. Tensiunea musculară prelungită poate produce durere, care poate duce la spasm muscular şi prin urmare la mai multă durere. 4. Tensiunea musculară are strânsă legătură cu modul nostru de a gândi; astfel, cu cât suntem mai stresaţi, cu atât mai mare va fi şi tensiunea noastră musculară. 5. Activitatea fizică prelungită cum ar fi mersul sau

36

ADINA RĂDULESCU

pasul alergător poate duce la oboseală musculară. 6. Care sunt cauzele principale ale extenuării musculare? 7. Muşchiul gastrocnemian este cel mai superficial muşchi situat în partea din spate a piciorului, care formează cea mai mare parte a gambei. 8. Tendonul lui Ahile este cel mai gros şi mai puternic tendon din corpul uman. 9. Muşchiul deltoid este un muşchi lat, gros, triunghiular, situat pe partea laterală şi posterioară a umărului. 10.Muşchiul abductor al policelui este un muşchi subţire, plat, îngust, plasat imediat dedesubtul tegumentului (integument). ►◄ Pair work: 8. Using your anatomy courses notes, choose a certain muscle and ask your deskmate to describe it. 9. Guessing game: Think of a certain muscle. Your deskmate will ask you as many questions as necessary to guess the muscle. Here are some examples of possible questions: • Is it a muscle of the trunk/head/upper limb/lower limb?→ for general location (It is a muscle of the upper limb) • Is it a muscle of the shoulder girdle or of the free upper limb?→ for specific location (It is a muscle of the shoulder girdle) • Where is it situated? (It arises from the clavicle and scapula.) • What is its function? (It helps the upper arm move forward, backward and horizontally.)

English in Kinetotherapy. A practical English handbook

37

• Can you describe it? (It is a thick, triangular muscle with the base facing upwards and the apex downwards) • Is it the deltoid muscle? (Yes, it is indeed.) The following classification of muscles may prove useful for this exercise: A. The muscles of the trunk: • the muscles of the back • the muscles of the neck • the muscles of the chest • the muscles of the abdomen B. The muscles of the head: → the muscles of facial expression: • the muscles of the scalp • the muscles surrounding the eyes • the muscles surrounding the mouth • the muscles surrounding the nose → the muscles of mastication C. The muscles of the upper limb: → the muscles of the shoulder girdle → the muscles of the free upper limb: • the muscles of the upper arm • the muscles of the forearm • the muscles of the hand D. The muscles of the lower limb: → the muscles of the hip joint

38

ADINA RĂDULESCU

→ the muscles of the free lower limb: • the muscles of the thigh • the muscles of the leg • the muscles of the foot 10. Complete the classifications above with all categories of muscles you have studied so far.

UNIT 4 EXAMINING THE PACIENT POLYSEMANTIC WORDS THERAPIST-PATIENT DISCOURSE – GREETINGS, IDENTIFICATION AND INTRODUCTORY DIALOGUES 1. Read the following text and check the glossary below to translate the unknown words. Write down other unknown words and try to approximate their meaning:

English in Kinetotherapy. A practical English handbook

39

EXAMINING THE PACIENT

“Examination of a pacient is a continuous process that starts with your first meeting and continues until treatment ceases prior to discharge. The initial examination leads to an assessment of the pacients` needs and a decision on the early treatment. If the pacient has been previously examined by a diagnostician who provides full notes, some useful and time-saving information may be obtained by their careful perusal. To use such notes to the maximum, divide your perusal into: ▪ Obtaining basic information about the pacient as a social entity: names, sex, marital status, age, current work, former job and/or retirement status, cultural background and family circumstances. ▪ Reading, in date order, the medical events that are former medical history and the events that have marked the development of the current illness/disability and its progress. ▪ Noting, if available, the clinical examination findings and the results of tests, including X-rays. Any abnormalities indicated by the medical examination sheet need to be checked by the present examiner, as different variables such as the subjective assessment of the previous examiner or the change in patient`s condition from the last examination may influence the course of the treatment.Knowledge of normal parameters should be used to decide whether any of the test records show a need for care in examination and treatment. ▪ Obtaining a record of immediate past and current treatment and medication. It is important that current medications are noted for these may have some effect on selection of or precautions in administrating your treatments. When examining the pacient some things need to be provided: a clean, well ventilated, adequately warmed area, suitable coverings for the pacient, the position of the examination couch or table in relation to the lighting and, quite important, verbal confidentiality.There are some small testing devices that the examiner needs: a tape measure, a pin, a goniometer, a reflex hammer, some cotton wool, test tubes containing hot and cold water.

40

ADINA RĂDULESCU

Escorting the patient to the examination area can be an opportunity to observe his/her ability to walk unaided, the type of gait abnormalities if any, the general mien and posture. Successful questioning produces maximum information with the minimum of questions and is a skill that improves with practice. Listening to the patient`s answers requires patience, instant awareness and interpretation, and listening to the silences is equally important.What the patient fails to say may have great relevance. Palpation is a skill that is acquired by practice. It requires that your hands should be relaxed, in firm comfortable contact, and aware of what is under them.The following procedures are to be used when palpating for specific anatomical features: place more of your hand than you need in contact with the area to be examined, lift your palm a little to reduce the contact, so that only the finger pads are touching firmly enough.Your fingers should be straight so that your nails are unlikely to be in contact. Remember that too hard a pressure will feel like a drill digging in and too light a pressure will feel like a butterfly coming to rest. In neither case will you feel or find anything. Always allocate sufficient time for an initial examination of the patient, and if the examination turns out to be more time-consuming than your original estimate, complete only part of the tasks and conclude the examination at a further session.” (Adapted from M.Hollis, P.Yung – Patient examination and assessment for therapists) GLOSSARY

to cease = a înceta, a se opri prior to = înainte de discharge = externare assessment = evaluare, estimare previously = mai înainte, în prealabil perusal = citire, lectură atentă former job = slujbă anterioară retirement = pensionare

English in Kinetotherapy. A practical English handbook

41

cultural background = formaţie culturală medical history = anamneză disability = incapacitate, invaliditate clinical examination findings = constatările examinării clinice medical examination sheet = foaie de observaţie clinică testing devices = instrumente de testare tape measure = ruletă, panglică de măsurat pin = ac cu gămălie goniometer = goniometru reflex hammer = ciocănel pentru testarea reflexelor cotton wool = vată test tube = eprubetă gait = umblet, mers mien = ţinută, comportament posture = postură corporală instant awareness = înţelegere rapidă palpation = palpare finger pad = buricul degetului drill = burghiu to dig in = a înfige 2. Scan the text above so as to answer the following questions: 1. Why is the patient`s initial examination important? 2. What should basic information about the patient include? 3. Why does the present examiner need to check the patient`s prior medical examination sheet? 4. Why does the examiner need to note the patient`s current medication? 5. What things need to be provided when examining the patient? 6. What testing devices does the examiner use? 7. What should the examiner observe while escorting the patient to the examination area?

42

ADINA RĂDULESCU

8. When can we say that questioning the patient has been successful? 9. What procedures are to be used when palpating the patient? 10. What should be done if the first examination takes longer than expected? 3. Create your own examiner – patient dialogues, including questions and answers regarding the patient`s basic information, former medical history, clinical examination findings, past and current medication, etc. ♣ VOCABULARY PRACTICE POLYSEMANTIC WORDS

Many words that are pronounced and spelt in the same way can be used in different contexts with different meanings. They are polysemantic words. Polysemy is closely related to homonymy and it is sometimes difficult to distinguish between words that are homonyms and words that are polysemantic. There is still a criterion that can help us distinguish one notion from the other: while with homonymy the words that have the same form do not share any semantic resemblance in their meanings, with polysemantic words we can easily notice a semantic feature common to all the elements of a class. Here are two examples for each notion: Heart, as a polysemantic word, has a semantic feature associated that of being the central part of a body, of one`s life or of something else - that is carried over from one example to the next: Even if his heart stopped beating for several seconds, he did not die. I think you should get to the heart of the matter. He is my heart, my reason of living. Calf as a young of cattle (viţel) or of certain other mammals such as the buffalo, elephant, giraffe and whale and calf as the thick fleshy part of the back of the leg between the ankle and the knee are two homonyms that have nothing in common, semantically speaking.

English in Kinetotherapy. A practical English handbook

43

Moreover, by looking words up in a dictionary, one can also distinguish between polysemantic words and homonyms as the former are listed with different numbers under the same lexical entry, while the latter are listed and treated as separate words: calf1 and calf 2. 4. Choose from among the meanings of the following polysemantic words the one that has been used in the text Examining the pacient: 1. examination means: a) written exercises, oral questions or practical tasks, set to test a candidate’s knowledge and skill; b) physical inspection of a patient or parts of his body, in order to verify health or diagnose disease; c) the formal interrogation of a person on oath (an accused or a witness) by a lawyer in a lawcourt. 2. discharge means: a) an official permission for (sb) to leave, after he has carried out a duty (discharge a soldier, a patient, release a prisoner from custody); b) unloading (cargo) from a ship c) firing (a gun), launching flying weapons (arrows) 3. background means: a) part of a view, scene or description that forms a setting for the chief objects, people; b) information that is needed to understand a problem; c) a person’s social class, education, training or experience; d) a low level of sound, lighting whose purpose is to be an unobtrusive or appropriate accompaniment to something else, such as a social activity, conversation or the action of a film.

44

ADINA RĂDULESCU

4. device means: a) a machine or tool adapted for a special purpose (timesaving device, safety device, an explosive device etc); b) a particular pattern of words, figures of speech used in literature to produce a certain effect on the reader; c) a written, printed or painted design or figure, used as a heraldic sign, emblem, trademark by a noble family; d) a plan or plot, esp. a clever or evil one; a scheme, trick. 5. Write your own contexts in which the polysemantic words above, except for the version of your choice, are used with other meanings. You can use the following expressions:

English in Kinetotherapy. A practical English handbook

• • • • • • • • • • • • • •

examination paper background music entrance examination working-class background to take an examination background on the company’s financial position pass/fail an examination time-saving device = aparat de uz caznic medical examination labour-saving device = dispozitiv mecanic to be under examination an explosive device = dispozitiv explozibil to stay/keep in the background stylistic device = figură de stil

5

English in Kinetotherapy. A practical English handbook

5

6. Match each of the meanings below to one of the seven polysemantic words in the box:

a. patient d. foot

b. tongue e. bottom

c. head f. spine

g. nerve

1. a movable organ in the mouth, used in tasting, licking, swallowing and speaking; 2. foam on the top of a poured beer; 3. a person who is receiving medical care in hospital; 4. part of the body on which one sits, buttocks; 5. a measure of length equal to 12 inches; 6. row of bones along the back of humans and some animals, backbone; 7. boldness, courage; 8. a person capable of accepting delay that can still remain calm; 9. part of the body, containing the eyes, nose, mouth and brain; 10. a language, dialect or idiom; 11. the lowest part of the leg, below the ankle, on which a person or animal sits; 12. ground under the sea, lake or river; 13. any of the bundle of fibres carrying sensory or motor impulses between the brain and all parts of the body; 14. any of the sharp needle-like parts on some plants (cactuses) and animals (hedgehogs); 15. chief person of a group or organization; 16. a flap of leather on a shoe, under the laces or buckles to protect the instep; 17. the lowest, deepest or farthest removed part of a thing; 18. the back part of a book that is visible when it is in a row on a shelf;

ADINA RĂDULESCU

6

19. rib or vein in a leaf or any of the veins of an insect`s wing; 20. mental ability or natural talent for something. 7. Write your own contexts for the different meanings of the polysemantic words above. You can make use of the following syntagms and expressions: • • • • • • • • • • • • • •

to be patient with sb. = a avea răbdare cu cineva mother tongue = limbă maternă to have lost/find one`s tongue = a-şi pierde/redobândi graiul the head of the family = capul familiei head office = sediu central to have a good head for business, figures = a avea cap de afaceri, cifre at the foot/bottom of the stairs/hill/ mountain/list/page = în partea de jos a … a 7-foot high wall = un zid înalt de 7 picioare to fall on one`s bottom = a cădea în fund the bottom of the sea/lake/river = fundul mării/lacului/râului to go to the bottom = a se scufunda to lose/regain one`s nerve = a-şi pierde/redobândi curajul to have the nerve to do smth.= a avea curajul/tupeul de a face ceva to strain every nerve = a-şi încorda toate puterile

English in Kinetotherapy. A practical English handbook

7

☼ THERAPIST-PATIENT DISCOURSE Greetings, identification and introductory dialogues Here are some examples of initial greetings and introductory dialogues used before the examination takes place:

The therapist: • Good morning, Mrs. Johnson. Let me introduce myself. I am your therapist, Dr. Green. • Please come in and take a seat. • Make yourself comfortable. I will be with you in a second. • My name is Dr.Green. I think we talked on the phone, didn`t we? • I remember you. You were my patient last year. How is your back? • You are Dr. Thomson`s sister, aren`t you? He told me all about you. Inquiring about the patient`s problem: • Well, Mrs. Johnson, what can I do for you? • Tell me, Mr. Baum, what`s troubling you? • Well, Mrs. Redcliff, what`s brought you here? • Well, let`s see… what seems to be the problem? • Your brother, Dr. Thomson tells me that you have been having low back pains… • I couldn`t help noticing your slight limp. Can you tell me more about it? • I can`t tell you how sorry I am about your terrible accident. How is your recovery going on? • I understand that you have seen several therapists before. How can I help you?

8

ADINA RĂDULESCU

Programming further sessions: • Considering your diagnosis, I will have to see you twice a week, for six weeks. • For the first two weeks we shall meet every day till your pain goes away. • Bring me the X-rays and then I will schedule a meeting for you for next week. • I am sorry, but you should have seen an orthopaedist before coming here. • I will meet you for our sessions three times a week, for at least three weeks. • We shall start on Monday and see how it is going. • I think we can have good results if you come to all your sessions. ►◄ Pair work 8. Practise therapist-patient dialogues using the examples above. You can as well come up with your own examples. 9. Translate into English, using the new vocabulary: 1. Recomandarea unui program de exerciţii terapeutice nu se poate face fără o examinare amănunţită a pacientului. 2. Orice informaţii cu privire la datele personale ale pacientului, la un diagnostic anterior şi medicamentaţie se pot dovedi extrem de importante în recomandarea terapiei ulterioare. 3. Pe toată durata examinării pacientul trebuie să se simtă relaxat, protejat, fiind asigurat de confidenţialitatea discuţiilor sale cu terapeutul. 4. Terapeutul poate sesiza în mod indirect anumite caracteristici motrice ale pacientului, prin simpla observare a

English in Kinetotherapy. A practical English handbook

9

posturii sale corporale, a ţinutei generale şi a mersului acestuia. 5. Palparea pacientului şi testarea gradului său de mobilitate sunt indicii clare în stabilirea afecţiunii prezente şi indicarea tipurilor de exerciţii corespunzătoare.

UNIT 5 TYPES OF INJURIES PASSIVE MODAL CONSTRUCTIONS PRESENT TENSE SIMPLE AND PRESENT PERFECT THERAPIST-PATIENT DISCOURSE – PATIENT`S SYMPTOMS AND COMPLAINTS FORMAL AND INFORMAL MEDICAL TERMS 1. Read the following extracts and check the glossary below for new words. Then translate these texts into Romanian: Patient rehabilitation after fractures “Patient rehabilitation should begin immediately, depending on the type of fracture and soft tissue stability. Adjacent joints should be mobilized as soon as possible; however, in open fractures motion of musculotendinous units over fracture surfaces will irritate the soft tissues and may decrease resistance to infection. Immobilization of adjacent joints can be done by using splints, braces or foot attachments to external fixation systems. Physical therapy should include active exercises for joint mobilization, weight-bearing exercises, as well as range of motion and strengthening exercises, all practised under the close supervision of both the physician and the kinetotherapist.” (Adapted from Thomas A. Russell – General Principles of Fracture Treatment)

10

ADINA RĂDULESCU

Hip dislocation “Hip dislocation is an orthopaedic emergency and must be reduced immediately. It occurs primarily in conjunction with severe multiple trauma from high-speed motor vehicle accidents. The longer the hip remains dislocated, the more likely is the possibility of complications, including avascular necrosis of the femoral head and posttraumatic arthritis. Most dislocations of the hip can be reduced by close manipulation and this treatment should take precedence over treatment of all other skeletal injuries.” (Adapted from David G. LaVelle – Acute Dislocations) Sprains or ligamentous injuries “Most sprains or ligamentous injuries can be treated by immobilization. Even though immobilization allows the stretching of ligaments, quickly relieves pain and may be beneficial in reducing the swelling, many specialists report that early mobilization for these injuries produces superior results to immobilization.” (Adapted from S. Terry Canale – Ankle Injuries) Rupture of muscles and tendons “The most frequent cause of partial or complete rupture of a muscle or tendon is eccentric overload of the muscle-tendon unit. Muscle strains are initially treated with ice, rest and antiinflammatory medication, followed by a gentle stretching and progressive strengthening program as symptoms resolve. Failure to regain full flexibility and normal strength of the muscle-tendon unit results in increased risk of further recurrent injury.” (Adapted from Barry B. Phillips - Rupture of muscles and tendons) GLOSSARY

rehabilitation = reabilitare fracture = fractură adjacent joint = articulaţie adiacentă to decrease = a reduce, diminua

English in Kinetotherapy. A practical English handbook

11

to increase = a mări, intensifica splint = atelă brace = orteză foot attachment = dispozitiv de fixare a piciorului weight-bearing exercise = exerciţiu de susţinere a greutăţii corporale range of motion = grad de mobilitate strengthening exercises = exerciţii de întărire musculară to occur = a se petrece, a avea loc in conjunction with = în legătură cu avascular necrosis = necroză avasculară femoral head = cap femural arthritis = artrită to take precedence over smth = a avea loc înainte, a avea prioritate faţă de skeletal injury = leziune a sistemului scheletic sprain = luxaţie, scrântire to relieve pain = a alina durerea swelling = umflătură rupture = ruptură, hernie overload = încărcare excesivă muscle strain = întindere musculară failure = eşec, insuficienţă further = ulterior, adiţional 2. Scan the texts above for modal constructions (can, may, should, must etc) and write them down. Then, underline the passive ones as in the examples below: Example: Should begin Should be mobilized

ADINA RĂDULESCU

12

■ GRAMMAR PASSIVE MODAL CONSTRUCTIONS All scientific languages make use of passive constructions to express impersonal observations, avoid mentioning unknown or indefinite subjects and focus on action and effect rather than on the agent that caused them. Even though the process of converting active constructions into passive ones seems to be artificial, it may prove to be useful and practical in situations when passives are preferred to active constructions. Here are some examples of passives constructions illustrated for modal verbs: Excessive flexion and extension of the neck should be avoided in spinal injuries. Clinical instability may be caused by trauma, neoplastic or infections disorders. Spinal alignment can be obtained by skeletal traction. The pathologic anatomy must be carefully defined before treatment is determined. These pills must be taken twice a day, on an empty stomach. With modal verbs the transformation from active voice to passive voice is made by keeping the modal unchanged and using a passive infinitive: Active Voice

→

Passive Voice

Should avoid → should be avoided (modal + BE + past participle – short inf.+ ED )

English in Kinetotherapy. A practical English handbook

13

Must take → must be taken (modal + BE + past participle – the 3rd form of irregular verbs) 3. Insert the following modal constructions in their corresponding context, choosing the active or passive form that best completes the sentence:

must be applied should wear first direct should be confirmed must be covered should not be done should not be rubbed

must be used should may be selected may be

1. Open hand wounds ………………. immediately with a sterile dressing to prevent further contamination. 2. If bleeding continues, manual or digital pressure …………… to the wound through the dressing. 3. At times it ………… helpful to elevate the arm with the patient lying supine. 4. Cleaning the wound …………………….. in a hurry. 5. Both the examiner and the patient ………….. masks when the wound is examined. 6. Sterile instruments and gloves …………………….. 7. The examiner …………… his attention to the circulation and skin and then to bones, tendons and nerves. 8. The depth of the wound ……………………… with a sponge or a brush. 9. Suspected damage to tendons and nerves …………………. by direct vision. 10. A regional block or general anesthetic …………… depending on the patient`s age and the severity of the injury. 4. Rewrite the following sentences in the passive voice, making the

14

ADINA RĂDULESCU

words in italics the subject of the sentence and placing, when necessary, the agent at the end of the sentence: Example: The surgeon should closely follow the progress of patient`s regeneration. The progress of patient`s regeneration should be closely followed by the surgeon (agent). 1. The examiner should advise the patient as to the extent of his injuries. 2. The surgeon must evaluate the extent of the skin loss from the injury. 3. The surgeons may delay the repairs of nerve and tendons. 4. During surgical procedures the assistants should use a double binocular microscope. 5. Surgeons can master microsurgical techniques only after countless hours of practice. 6. The surgeon must avoid coffee just before surgery. 7. If suitable instruments are available and if the surgeon is rested he may undertake repair of severed nerves on the day of injury. 8. During weeks after nerves repair operation the patient should pay careful attention to avoid fixed contractures. 9. After the operation the patient should begin progressive strengthening exercises. 10. The patients should also make monthly clinical evaluations.

5. Translate into English using passive modal constructions: 1. Pacientul suspectat de fractură a coloanei vertebrale nu trebuie mutat până la sosirea ajutorului calificat. 2. Dacă este imperativ ca pacientul să fie mutat,

English in Kinetotherapy. A practical English handbook

15

capul, gâtul şi toracele lui trebuie susţinute în poziţia lor iniţială de către mai multe persoane. 3. Această plagă ar trebui curăţată imediat iar fractura deschisă ar trebui imobilizată. 4. Primul ajutor în caz de rănire trebuie să fie întotdeauna rapid, eficient şi de preferinţă efectuat de către personal calificat. 5. Programul de recuperare motorie a pacientului ar trebui început la câteva săptămâni după operaţie. ☼ THERAPIST-PATIENT DISCOURSE Patient`s symptoms and complaints Formal and informal medical terms Patients and therapists/doctors do not always use the same language, even if they are speaking about the same things. There is a certain difference between a formal medical language used between doctors and medical care takers, the scientific language of all medical texts and an informal medical language that non-specialists (patients) use to describe their symptoms or disabilities. In therapist-patient communications a common informal language should be used to ensure proper communication. Here are some examples of the same notions with different formal vs. informal medical terms: Formal term contusion tenosynovitis arteriosclerosis sedative analgesic

Informal term bruise

Translation contuzie, vânătaie inflamed tendons tenosinovită hardening of the arteroscleroză arteries sleeping pill, dope sedativ pain killer analgezic, calmant

6. Match the formal term in column A with its corresponding informal term in column B:

ADINA RĂDULESCU

16

A 1. thyroid cartilage 2. halitosis 3. maxilla 4. alopecia 5. spine 6. tachycardia 7. mandible 8. myocardial infarction 9.ankylosing spondylitis 10. subluxation 11. thorax 12. influenza 13. hypoglycaemia 14. uterus 15. vertigo

B a. dizziness b. bamboo spine c. lower jaw d. palpitations e. heart attack f. Adam`s apple g. low blood sugar h. bad breath i. womb j. backbone k. flu l. chest m. dislocation n. upper jaw o. baldness

Without assuming to cover at least part of the symptoms and problems that patients may have when coming to see a kinetotherapist, some examples of common complaints are presented below: Patient`s symptoms and complaints: • • • • •

I have sprained my left ankle. (Mi-am răsucit/ luxat glezna stângă) I have strained my deltoid muscle. (Am o întindere musculară la deltoid.) I have pulled a hamstring muscle. (Mi-am întins un tendon muscular.) I have torn a ligament in my right knee. (Am o ruptură ligamentară la genunchiul drept.) I have snapped a tendon in my left thigh. (Am o ruptură de tendon la coapsa dreaptă.)

English in Kinetotherapy. A practical English handbook

• • • • • • • • •

17

I have got a cartilage problem in my left knee joint. (Am o problemă la nivelul cartilajului articulaţiei genunchiului stâng.) I have got chilblains in my toes. (Am suferit degerături la degetele de la picioare.) I have pins and needles in my feet all the time. (Simt furnicături în picioare tot timpul.) I feel a tingling sensation in my fingers. (Simt o senzaţie de furnicături în degete.) I have got a severe pain in my left heel. (Am o durere puternică în călcâiul stâng.) I get cramp in my calves. (Am crampe la gambe.) I have got swelling of my ankles. (Am gleznele umflate.) I have got numb fingers/legs when I wake up. (Am degetele/picioarele amorţite când mă trezesc.) My fingers tremble a lot and even my hands have started shaking.(Îmi tremură degetele şi chiar şi mâinile.)

■ GRAMMAR Present Perfect and Present Tense Simple are the tenses normally used to express complaints in the above sentences. 7. Identify each tense in the sentences above and say how they are formed. Example: Have sprained = Present Perfect Simple; formation: the auxiliary verb have + past participle of the regular verb sprain (short infinitive + -ed) Have torn = Present Perfect Simple; formation: the auxiliary verb have + past participle of the irregular verb tear (tear, tore, torn)

18

ADINA RĂDULESCU

Present Perfect Simple is used in the above-mentioned complaints to express previous causes/injuries that still have a certain effect in the present, while Present Tense Simple makes these complaints a general fact, the symptoms presented are something felt as usual. 8. Put the verbs in brackets into the Present Tense Simple or Present Perfect: 1. _______ you ever ________ (sprain) your ankle? It`s not so bad but you have to stay in bed for a while. 2. _______ it _________ (hurt) if I touch your swollen ankle? ______ you _______ (feel) a burning sensation? 3. My aunt`s fingers always __________ (tremble) when she ________ (give) me my monthly allowance. 4. I am still in hospital. I ________________ (not recover) yet. I always ______ (get) cramps in my calves in the morning. 5. I ________ already _________ (practise) this stretching exercise three times. Yes, but you still ___________ (not do) it right. 9. Translate into English using Present Perfect Simple and Present Tense Simple as in the above-presented examples of patient`s complaints; sometimes modal verbs are to be used as well: 1. Nu pot să-mi îndoi cotul drept. Cred că mi l-am luxat. 2. Mi-am fracturat şoldul şi am nevoie de exerciţii de reabilitare. 3. Mi-am dislocat umărul stâng. Aş dori să am un grad mai mare de mobilitate. 4. Mi-am rupt trei coaste într-un accident de schi. Am fost în spital şase săptămâni. 5. Am adesea crampe durerose în ambele gambe după terminarea meciului de fotbal.

English in Kinetotherapy. A practical English handbook

19

6. Când mă scol dimineaţa nu-mi simt picioarele de la genunchi în jos. 7. Am dureri de spate acute. Am fost la mulţi doctori şi m-am horătât să încerc şi nişte exerciţii terapeutice. 8. Am o întindere musculară supărătoare la nivelul gâtului. Am nevoie de câteva exerciţii de întindere pentru a-mi redobândi flexibilitatea. 9. Am o ruptură de tendon în deltoid şi nu-mi pot continua programul de antrenament pentru Olimpiadă. 10.Am contracţii musculare în gamba stângă iar forţa mea musculară nu mai este aceeaşi. 10. Place yourself in a patient`s situation and complain about your symptoms, asking your colleagues – future kinetotherapists for help and advice.

UNIT 6 THERAPEUTIC EXERCISES WORD FORMATION – DERIVATION THERAPIST-PATIENT DISCOURSE – RECOMMENDING DIFFERENT THERAPEUTIC EXERCISES 1. Read the following text and write down the new words; then translate it into Romanian, using the glossary below. THERAPEUTIC EXERCISES “The goals of therapeutic exercises include the prevention of dysfunction as well as the development, improvement, restoration or maintenance of strength, endurance and cardiovascular fitness, mobility and flexibility, stability, relaxation, coordination, balance and

20

ADINA RĂDULESCU

functional skills. Strength is the ability of a muscle or muscle group to produce tension and a resulting force during a maximal effort, either dynamically or statically, in the relation to the demands placed upon it. To increase strength, a load that exceeds the metabolic capacity of the muscle must be used during exercise. To produce greater muscular tension, a high-intensity exercise (exercise performed against heavy loads) must also be used, but for a relatively low number of repetitions. Muscular endurance is the ability of a muscle to contract repeatedly or generate tension, sustain that tension and resist fatigue over a prolonged period of time. It is necessary for performing repeated motor tasks in daily living, such as walking or climbing stairs. Active exercises that challenge the oxygen transport system will increase endurance - the major goal of cardiac rehabilitation programs. Exercises are usually directed to large muscle groups, as in walking, running, swimming and cycling and are to be prolonged and performed for 15 to 45 minutes or more. Mobility of soft tissues and joints is necessary for the performance of normal functional movements. Flexibility is the ability to move a single joint or series of joints through an unrestricted, pain-free range of motion. It is dependent upon the extensibility of muscles, which allows muscles that cross a joint to relax, lengthen and yield to a stretch force. Stability is usually required in more proximal structures, such as the trunk, hips and shoulder girdle, for effective positioning and motion of the arms and hands or legs and feet.Stabilization exercises are the means by which a patient can learn to control proximal areas of the body and, at the same time, maintain a stable, well-aligned position while carrying out functional activities. Relaxation refers to a conscious effort to relieve tension in muscles.Exercises promoting relaxation are based on the therapeutic use of reflexive and conscious processes. Thus, the patient should be placed in a comfortable position, with all body parts well supported and be taught to progressively contract and relax the musculature.This

English in Kinetotherapy. A practical English handbook

21

process is often coupled with deep-breathing exercise to further promote relaxation. Coordination, balance and the acquisition of functional skills are all interrelated and are complex aspects of motor control. Coordination refers to the ability to use the right muscles at the right time with appropriate intensity. It is the basis of smooth and efficient movement that can occur on a voluntary or involuntary level. Balance refers to the ability to maintain the center of gravity over the base of support, usually while in an upright position. It is a dynamic phenomenon that involves a combination of stability and mobility. Finally, functional skills refer to the varied motor skills necessary to function independently in all aspects of daily living. Learning functional motor tasks involves constant repetition of simple to more complex motor activities, use of sensory cues (tactile, visual) to enhance motor performance and as the quality of movement improves, so should the speed and timing of movements.” (Adapted from Carolyn Kisner&Lynn Allen Colby – Therapeutic Exercise. Foundations and Techniques) GLOSSARY dysfunction = disfuncţie restoration = refacere, restabilire maintenance = menţinere strength = forţă, vigoare endurance = rezistenţă fizică cardiovascular fitness = tonus cardiovascular balance = echilibru functional skills = abilităţi funcţionale load = greutate a high-intensity exercise = exerciţiu cu intensitate crescută fatigue = oboseală motor tasks = sarcini motorii

22

ADINA RĂDULESCU

to challenge = a solicita range of motion = grad de mobilitate to lengthen = a se lungi, întinde to yield to = a ceda, a nu rezista la stretch force = forţă de întindere stable = stabil well-aligned position = poziţie corect adoptată carry out = a îndeplini, a realiza to relieve = a destinde, relaxa deep-breathing exercise = exerciţiu de respiraţie profundă acquisition = dobândire, obţinere smooth movement = mişcare lină, fără întreruperi upright position = poziţie verticală sensory cues = indici senzoriali to enhance = a mări, intensifica motor performance = randament motoriu timing = sincronizare ►◄ Pair-work 2. Question-answer exercise: Reread the text above on paragraphs. One student will ask his/her colleague one or two questions for each paragraph and he/she should answer it either by reproducing fragments from the text or by freely expressing a summary of that fragment. Here is an example for the first paragraph: Example: What are the main goals of therapeutic exercises? Well, if I remember corectly, the goals of therapeutic exercises are…………. How is strength defined in the text? Well, let my see, strength is defined as ………..

English in Kinetotherapy. A practical English handbook

23

What should be done to produce greater muscular tension? Well, it says here that a high-intensity exercise…. 3. Question-answer exercise: Try to find out how much you really know about your physical abilities. Ask your deskmate to make a self-evaluation of his/her physical abilities (strength, muscular endurance etc.); in your answers you can make use of the following assessment patterns or come up with new ones: • • • • •

Well, my strength is quite bad/ is not so bad/ is actually quite good/ is excellent…. Muscular endurance is not my stong point, if you get my meaning. As for my mobility and flexibility, it goes without saying that all I need is a little practice, to get back into shape. Well, my stability depends a lot on my mental stability; a state of nervousness will certainly be detrimental to my stability. I have always had problems with balance; to me, it is sometimes that does not improve with practice; you either have it or not.

WORD FORMATION – DERIVATION Derivation with suffixes and prefixes is one of the means of word formation. Generally, there are some typical noun/ adjective/ adverb/ verb – forming suffixes and prefixes, but there are cases when the same prefix or suffix is used to form different categories. For instance the suffix –al is used to form both nouns like in arrival, refusal, proposal and adjectives like in functional, educational. The suffix – ing is used to form the present participle that can be used as a verbal category (She came walking across the field.), as a noun (Walking can sometimes be very relaxing.) or as an adjective (He was reading a very amusing novel.). The suffix –ly is the most common adverbforming suffix (rapidly, daily, usually). Still, there are some adjectives

24

ADINA RĂDULESCU

that contain the –ly suffix: daily schedule, monthly payment. The following exercises are meant as forms of practising the word formation process. 4. Extract from the text above (Therapeutic exercises) all the derivational nouns and include them into their corresponding suffix category as shown in the example: Example: -ion: prevention -ment: development -ance: maintenance -ness: fitness -ity: mobility -ing:walking 5. Find the corresponding base forms (verbs, adjectives) and the corresponding suffixes for every derivational noun in the same text: Example: prevention ← prevent (verb) + -ion (suffix) mobility ← mobil (adjective) + -ity (suffix) 6. Extract from the text above (Therapeutic exercises) all the derivational adjectives and include them into their corresponding suffix category: Example: -ic: therapeutic -al: functional -ing: resulting -ed: prolongued -ive: effective -ly: daily -(i)ous: conscious -able: comfortable

English in Kinetotherapy. A practical English handbook

25

-y: sensory 7. Find the corresponding base forms (nouns, verbs) and the corresponding suffixes for every adjective in the text: Example: therapeutic ← therapeut (noun) + -ic (suffix) 8. Extract from the text above (Therapeutic exercises) all the derivational adverbs and include them into their corresponding suffix category: Example: -ly: relatively -ally: dynamically 9. Find the corresponding base forms (adjectives) and the corresponding suffixes for every adverb: Example: relatively ← relative (adjective) + -ly (suffix) There are many nouns in English that have an identical form with their corresponding verbs: Verbs to pressure to question to estimate to exercise

Nouns pressure question estimate exercise

Yet, sometimes there are some slight spelling differences between the noun and its corresponding verb that can easily pass unnoticed: Verbs To practise To respond

Nouns practice response

ADINA RĂDULESCU

26

10. Give other examples of nouns that have the same form as their corresponding verbs and write contexts in which the same word functions both as a noun and as a verb. 11. Write in the second column the corresponding nouns for the verbs listed in the first column. The first one has been done for you as an example: include 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13.

examine prescribe operate assess decide retire interpret confirm immobilize rehabilitate swell treat dislocate

inclusion_ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________

12. Rewrite the sentences below using the nouns in the second column (exercise 11) instead of their corresponding verbs. Do not change the meaning of the sentences: Example: It was more than vital to include Mr. Dean in our clinical study. Mr. Dean`s inclusion in our clinical study was more than vital. 1. I will be able to tell you more after I examine the patient.

English in Kinetotherapy. A practical English handbook

27

2. You should not take these pills if the doctore did not prescribe them. 3. The surgeons operated on the injured man immediately. 4. After the therapist assesses the patient`s needs, he will also decide a further treatment. 5. As Mrs. Strauss retires next month, she will have more time for her therapy. 6. After the doctor interprets the results of your X-rays, he will probably confirm your need for surgery. 7. To immobilize the patient`s fractured leg is one of the first aid measures to be taken. 8. Our clinic is specialized in rehabilitating patients who suffered severe injuries. 9. What can I do if my ankle swells over night? 10. I cannot treat patients without their full consent and cooperation. 11. If the patient`s shoulder is dislocated, an emergency intervention is needed. ☼ THERAPIST-PATIENT DISCOURSE Recommending different therapeutic exercises Listening to the patients`complains and symptoms will normally be followed by the therapist`s recommandations regarding different therapeutic techniques and exercises. Here are some examples of such kinetotherapy exercises that therapists may recommend to their patients:

Kinetotherapist`s recommandations: • •

You should start with a very simple relaxation technique. A deep-breathing exercise will help you relax.

ADINA RĂDULESCU

28

• • • • • • • •

Some massage sessions will be good for your local circulation. Passive stretching exercises will lengthen your shortened tissues. You can practise these self-stretching exercises as part of your home exercise program. As a gymnast, do not forget to practise your overstretching exercises. Considering your long-term immobilization, you need to practise strengthening exercises every day. The best solution for you to regain your balance is to practise weight-bearing exercises. I recommend you to continue with joint mobilization techniques to treat your muscular stiffness. In treating your spine injury, traction techniques are a good option.

13. Translate the above sentences into Romanian and say whether you are familiar with these exercises; give examples of such types of exercises. 14. Consider yourself as a kinetotherapist; choose one type of the exercises above and explain the basic procedure to a colleaguepatient of yours. 15. Consider yourself as a patient with a certain dysfunction (you can choose one of the symtoms presented in Unit 5) and ask your colleague-therapist what exercises he would recommend you. 16. Translate into English using the new vocabulary: 1. Este foarte important să-ţi alegi un program de exerciţii care să-ţi fie cu adevărat de ajutor.

English in Kinetotherapy. A practical English handbook

29

2. Exerciţiile de menţinere a greutăţii corporale ar trebui să înceapă cu reînvăţarea schimbării greutăţii corporale. 3. Dacă vrei să-ţi corectezi postura corporală defectuoasă ar trebui să începi cu exerciţii de întărire a musculaturii slăbite. 4. Exerciţiile de întindere sunt recomandate persoanelor în vârstă, indivizilor sedentari şi persoanelor care se refac după operaţii sau o imobilizare prelungită. 5. Creşterea rezistenţei musculare va duce implicit la îmbunătăţirea tonusului cardiovascular. 6. Tehnicile de mobilizare a articulaţiilor sunt folosite în tratarea atrofiei cartilajului articular, a slăbirii ligamentoase, a hipomobilităţii articulare ş.a.m.d. 7. Tehnicile de tracţiune sunt practicate pentru a se redobândi flexibilitatea, forţa, rezistenţa şi stabilitatea coloanei vertebrale. 8. Poţi să-ţi menţii echilibrul timp îndelungat pe o suprafaţă îngustă şi fiind legat la ochi? 9. Rezistenţa musculară nu este intotdeauna rezultatul antrenamentelor susţinute. Urcatul şi coborâtul scărilor într-un bloc fără lift, alergatul după autobuz sau mersul pe jos ne ţin în formă în fiecare zi. 10.Toate capacităţile noastre fizice pot fi perturbate atunci când sunt nevoiţi să fim imobilizaţi la pat pentru o perioadă prelungită de timp.

UNIT 7 THERAPEUTIC PATIENT

PROCEDURES

IN

HANDLING

THE

30

ADINA RĂDULESCU

PASSIVE VERBAL CONSTRUCTIONS THERAPIST-PATIENT DISCOURSE – positioning and handling the patient 1. Read the following extracts and then solve the tasks that follow them: “Movements at a joint are determined by the shape of the articular surfaces. For instances, the following movements are possible at the shoulder joint: flexion and extention about the transverse axis with the movements occurring in the saggital plane; abduction and adduction about the anteroposterior axis, in which case the movement is made in the frontal plane; and finally, rotation about the vertical axis including pronation (medial rotation) and supination (lateral rotation), with the movement occurring in the horizontal plane.” (R. D. Sinelnikov – Atlas of Human Anatomy) Weight-bearing control and stability “Develop ability to shift the body weight. If the patient cannot bear full weight, begin in the parallel bars with part of the weight borne on the hands. The patient shifts anteriorly, side to side, and obliquely. Manual resistance to the motion is added with pressure against the patient`s pelvis.” To increase flexion of the hip with the knee extended Hand placement: “With the patient`s knee fully extended, support the patient`s lower leg with your arm or shoulder. Stabilize the opposite extremity along the anterior aspect of the thigh with your other hand or a belt or with the assistance of another person. With the knee in maximum extension, flex the hip as far as possible. Alternate position. Kneel on the mat and place the patient`s heel against your shoulder. Place both of your hands along the anterior aspect of the distal femur

English in Kinetotherapy. A practical English handbook

31

to keep the knee extended. The opposite extremity is stabilized in extension by a belt or towel and held in place by the therapist`s knee.” To increase dorsiflexion of the ankle with the knee extended Hand placement “Grasp the patient`s heel (calcaneus) with one hand. Stabilize the anterior aspect of the tibia with your other hand. Pull the calcaneus downward with your thumb and fingers and gently push upward on the heads of the metatarsals.” To increase wrist extension Hand placement “Pronate the forearm and grasp the patient at the palmar aspect of the hand. Stabilize the forearm. To lengthen the wrist flexors, extend the patient`s wrist, allowing the fingers to passively flex. Alternate position: Support the patient`s forearm on the table but allow the hand to drop over the edge of the table. Then passively extend the wrist. This may be more comfortable for the therapist or necessary if the patient has a severe wrist flexion contracture.” (Carolyn Kisner&Lynn Allen Colby – Therapeutic Exercise. Foundations and Techniques) TASKS 1. Enumerate the movements that are possible at the shoulder joint. 2. Name the type of therapeutic exercise that deals with controlling body weight. 3. What is hand placement? 4. Which parts needs to be stabilized in: hip flexion, ankle dorsiflexion and wrist extension? 5. What should the therapist do to to lengthen the wrist flexors? 6. What is recommended if the patient has a severe wrist flexion

ADINA RĂDULESCU

32

contracture? 7. What objects does the therapist use in handling the patient? 8. Pair work: Choose one of the last three therapeutic procedures and illustrate them, respecting the indications offered in the texts. 9. Pair work: Repeat the task at point 8, this time with the therapist describing the procedure (in his /her own words) while illustrating it in front of the class. 10. Invent one type of exercise for a certain purpose, first practise it with your deskmate and then, describe it to your audience. 2. Complete the missing correspondent in the following verb-noun pairs: VERBS

NOUNS flexion extension abduction adduction rotation

to pronate to supinate resistance pressure to stabilize to lengthen to support 3. Complete the missing correspondent in the following adjectiveadverb pairs: ADJECTIVE possible manual

ADVERB anteriorly

English in Kinetotherapy. A practical English handbook

33

obliquely comfortable necessary gently passively fully horizontal severe ■ GRAMMAR PASSIVE VERBAL CONSTRUCTIONS In Unit 5 we have already introduced the issue of Passive Voice and exemplified its use in dealing with passive modal constructions. Learning how to use the passive forms of the most frequently used verbal tenses is the objective of this unit. As a general rule, the passive voice is formed by putting the verb to be into the same tense as the verb in the active voice and adding the past participle of the active verb. The direct object of the active verb becomes the subject of the passive verb, while the subject of the active verb becomes the agent of the passive verb. Example: Therapists sometimes hypnotize their patients. ↓ ↓ subject direct object The patients are sometimes hypnotized by their therapists. ↓ ↓ subject agent

Read the chart below to see how the active to passive

ADINA RĂDULESCU

34

transformation works for the main verbal tenses: TENSES Present Tense Simple Present Tense Continuous Past Tense Simple Past Tense Continuous Present Perfect Past Perfect Future Tense Simple Future Perfect Conditional Perfect Conditional Gerund

ACTIVE VOICE treat

is/are examining injured was/were transporting has/have found had discharged will/shall include will/shall have healed would recover would have saved practising

PASSIVE VOICE am/is/are treated is/are being examined was/were injured was/were being transported has/have been found had been discharged will/shall be included will/shall have been healed would be recovered would have been saved being practised

4. Put the verbs in brackets into the passive voice of the tense indicated: Example: The range of motion of the ankle is restored (restore – Present Tense Simple) by performing stretching exercises. 1. The ankle ___________________ (immobilize – Present Tense Simple) in a short cast for 3 to 4 weeks. 2. The patient`s lower leg ___________________ (elevate –

English in Kinetotherapy. A practical English handbook

35

Present Tense Continuous) now. 3. Successive weight-bearing stresses ________________ (impose – Past Tense Simple) on the feet. 4. These faulty foot postures __________________ (cause – Present Perfect) by the excessive adduction of the forefoot. 5. The rehabilitation program ________________ (start – Future Tense Simple) as soon as possible. 6. Little effort _______________ (require – Present Tense Simple) to maintain this position for extended periods. 7. Ankle and foot motions ________ previously ____________ (perform – Past Perfect) by the patient. 8. The same motion ____ now ____________ (repeat – Present Tense Continuous) with the patient in alternate position. 9. Many balance activities _________________ (practise – Past Tense Simple) but without any result. 10. Muscular endurance _________________ (increase – Present Perfect) by performing the same exercises for a repeated number of times. 5. Change the following sentences from Active Voice into Passive Voice; the underlined direct objects will become the subjects of the passive sentences: Example: The patient sometimes describes pain from muscle spasm as a headache. Pain from muscle spasm is sometimes described as a headache. 1. If the patient is experiencing acute inflammation, he should be placed in a less irritating position. 2. If a disk lesion is the cause of the acute back pain, the therapist will first take measures to alleviate the pain. 3. Injury or degeneration of the disk affects spinal mechanics in general.

ADINA RĂDULESCU

36

4. The patient with acute disk lesions has avoided sitting with the hips and knees flexed or leaning forward. 5. The patient needs bed rest during the first 2days when symptoms are highly irritable. 6. The therapist will instruct the patient to avoid flexion activities that increase intradiskal pressure. 7. In one of my patients with spondylosis, traction exercises temporarily relieved the pressure. 8. Many patients have often expressed emotional stresses as increased tension in their lumbar region. 9. The patient performs elongation exercises only within tolerance during the early healing phase. 10. Imbalances in the shoulder girdle will perpetuate faulty postures. ☼ THERAPIST-PATIENT DISCOURSE Positioning and handling the patient ►◄ Pair work 6. Read the following positioning indications to your colleaguepatient who will then illustrate them in front of the classs: • • • • • • • • •

The patient is supine, with arms in resting position. The patient is side-lying, with the affected hip up. The patient is hook-lying. The patient is cross-sitting. The patient is heel-sitting. The patient is on hands and knees. The patient is prone, with hands placed under the shoulders. The patient is supine, with the foot pointing upright to keep the hip neutral to rotation. The patient is sitting, with the forearm supported on the treatment table, wrist over the edge of the table.

English in Kinetotherapy. A practical English handbook

•

37

The patient is standing, with the hands placed in the low-back area.

☺Team work 7. Read the following hand placement and stabilization procedure indications to a therapist-patient pair who will then illustrate them in front of the classs. • • • • • • •

Grasp the patient`s wrist with your lower hand. Place your thumb on the anterior surface of the proximal end of the clavicle. Place a belt around your shoulder and under the patient`s thigh to help hold the weight of the lower extremity. Support the patient`s leg with the fingers of the top hand under the patient`s knee and the lower hand under the heel. Stabilize the patient`s pelvis with the top hand or arm. Stabilize the patient`s pelvis by flexing the opposite hip and holding the thigh with the hands. The hip to be mobilized is in resting position. Sitting on a low stool, stabilize the leg between your knees and place one hand on the anterior aspect of the tibia.

☺Team work 8. Read the following therapeutic techniques to a therapist-patient pair who will then illustrate them in front of the classs: • • • •

Perform elbow flexion and extension with the forearm pronated as well as supinated. Flex the patient`s hip and knee to 90 degrees; support the knee with the top hand. Pull the foot away from the long axis of the leg in a distal direction by leaning backward. Flex the elbow to 90 degrees and abduct the shoulder to 90

ADINA RĂDULESCU

38

• • •

degrees. Rotate the humerus by moving the forearm like a spoke on a wheel. Flex the patient`s knee until discomfort is experienced in the anterior thigh. Instruct the patient to arch the back by pressing against the floor with the back of the neck and the sacrum.

9. Translate into Romanian all the sentences from the exercises 6, 7 and 8 above. ►◄Pair work 10. One student will be given a hand out containing indications for a therapeutic exercise. He or she will read the text and then start illustrating the stages of the exercise. The task for the other student is to write down the content of the exercise while watching it. The exercise will be repeated several times. At the end the teacher or a third student will compare the two texts and comment on their degree of similarity. Here is an example of a hand out: Example: The patient is standing, with the hands placed on the shoulders. The patient bends his body sideways with one hand over his head. The movement is repeated three times for each side. Then the patient returns to the initial position. 11. Create your own therapeutic exercises, using the examples provided in this unit and read them to your colleagues. 12. Translate into English, using the new vocabulary of this unit: 1. Plasaţi pacientul în poziţie de supinaţie, cu

English in Kinetotherapy. A practical English handbook

39

mâinile întinse lateral. 2. Prindeţi încheietura mâinii pacientului şi rotiţi-i braţul. 3. Indicaţi-i apoi pacientului să încerce să facă aceeaşi mişcare singur. 4. Poziţie iniţială: pacientul aflat în sprijin pe mâini şi genunchi. 5. Indicaţi-i pacientului să-şi menţină greutatea corporală pe mâini şi genunchiul stâng şi să-şi întindă uşor genunchiul drept în spate. 6. Greutatea corporală va fi apoi mutată pe mâini şi pe genunchiul drept iar piciorul stâng va fi întins. 7. Poziţie iniţială: pacientul este în poziţia stând pe călcâie. Indicaţi-i pacientului să se aplece în faţă, cu capul între braţele întinse, până ce abdomenul se va odihni pe coapsele anterioare. 8. Poziţie iniţială: pacientul este aşezat pe-o parte, pe masa terapeutului, cu capul plasat la marginea mesei. 9. Indicaţi-i pacientului să-şi întindă mâna de deasupra peste cap, lăsând-o să atârne pe lângă masă. Poziţia trebuie menţinută pentru câteva minute. 10.Aceeaşi mişcare se va repeta pentru braţul opus, cu pacientul aşezat în poziţie simetrică.

UNIT 8 MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS PRONOUNCING TONGUE-TWISTERS DESCRIBING SYMPTOMS AND RECOMMENDING THERAPEUTIC EXERCISES 1. Read the following definitions and match the names of the

ADINA RĂDULESCU

40

disorders listed below with their corresponding definitions: 1. 2. 3. 4. 5. 6. 7.

Osteoarthritis Rheumatoid Arthritis Ankylosing Spondylitis Osteoporosis Low Back Pain Tendinitis and Tenosynovitis Amyotrophic Lateral Sclerosis

A. A systemic inflammatory disorder affecting primarily the spinal column and the large peripheral joints and eventually resulting in hardening and deformity of the affected skeleton. B. A generalized, progressive reduction of bone mass as bone resorption outstrips bone formation, causing skeletal weakness and fractures. C. A chronic degenerative disease process occurring primarily in the hips and knees and characterized by deterioration of the joint cartilage, formation of new bone in subchondral areas and joint margins, and joint hypertrophy. D. May be caused by a muscle sprain or strain, arthritis, a tumor, or a ruptured cartilage disk between vertebrae. Other causes are poor posture, obesity, enlarged prostate gland, sagging abdominal muscles, sitting for prolonged periods of time, or excessive physical effort involving the back muscles. E. A rapidly progressive, degenerative disease of the upper and lower motor neurons characterized by atrophy of the hands, arms, legs, and, eventually, the entire body. Seventy percent of individuals die within 5 years of diagnosis.

English in Kinetotherapy. A practical English handbook

41

F. A chronic systemic degenerative disease characterized by inflammation of the connective tissues and manifested primarily in and around peripheral joints. G. An inflammation of the tendon and lining of the tendon sheath characterized by pain on movement of the associated joint. 2. Translate the definitions above into Romanian, using the words in the glossary:

GLOSSARY

disorder = disfuncţie, afecţiune, boală primarily = în primul rând to harden = a întări bone resorption = resorbţie osoasă to outstrip = a depăşi, întrece subcondral areas = zone subcondrale ruptured cartilage disk = disc cartilaginos rupt poor posture = postură defectuoasă sagging muscles = muşchi căzuţi, lăsaţi lining = îngroşare tendon sheath = teacă/înveliş al tendonului ♦ PRONOUNCING TONGUE-TWISTERS

Mastering stress-emphasis is one of the keys to pronouncing multisyllable medical terms. English makes use of a primarily/strong stress ( that has this graphic symbol: ') placed before the stressed syllable and of a secondary/weaker stress (that has this graphic symbol¸ ) that usually precedes the primarily stress, especially in multi-syllable words. Example:

ADINA RĂDULESCU

42

circulation [¸s∂: kju'leiſn ] inflammation [¸infl∂'meiſ∂n ]

□□■□ □□■□

Note – for the following pronounciation exercises each student should make use of an English dictionary that contains phonetic transcription. 3. Place the following two-syllable words in their corresponding stress-emphasis pattern:spinal, disease, column, weakness, fracture, prostate, muscle, tumor, posture, rotate, treatment, ankle, discharge, bandage, acute. Example: first syllable stress

second syllable stress

■□

□■

spi - nal

ro - tate

4. Place the following three-syllable words in their corresponding stress-emphasis pattern: atrophy, progressive, reduction, skeleton, excessive, cartilage, formation, disorder, arthritis, physical, systemic, lateral, sclerosis, surgery, maximum, resistance, endurance, effective. Example: first syllable stress

■□ □ a - tro – phy

second syllable stress

□■□ sys - te - mic

5. Place the following four-syllable words in their corresponding stress-emphasis pattern: vaccinated, peripheral, saturated, pulmonary, pneumonia, diagnosis, emergency, compatible, penicillin, deformity, circulation, independent, hypertrophy, spondylitis, tendinitis, ability, relaxation, alternative, combination, voluntary, phenomenon, restoration.

English in Kinetotherapy. A practical English handbook

Example: first syllable stress

43

second syllable stress

■□ □ □

□■□□

vac-ci-na-ted

pneu-mo-ni-a

third syllable stress

□□■□ in-de-pen-dent 6. Find the corresponding stress-emphasis pattern for the following multi-syllable words and draw their graphic reprezentation: degenerative, deterioration, individual, osteoarthritis, osteoporosis, tenosynovitis, amyotrophic, cardiovascular, rehabilitation, musculoskeletal, extensibility, pathophysiologic. Example: De-ge-ne-ra-tive

□■□□□

DESCRIBING SYMPTOMS THERAPEUTIC EXERCISES

AND

RECOMMENDING

Read about the main causes and symptoms of the musculoskeletal and connective tissue disorders in the following chart: The disorder 1. Osteoarthritis

Causes The etiology is unknown but is believed to be related in some way to aging and genetics. Men and women are equally affected, but the

Symptoms early symptoms: deep, aching joint pain that is aggravated by exercise and that worsens as the day progresses; stiffness following inactivity. midcourse symptoms:

44

ADINA RĂDULESCU onset in men occurs earlier. In women, the incidence increases after menopause.

2.Rheumatoid Arthritis

The etiology is unknown but the disease is often characterized as an autoimmune disorder, and a familial link is suspected; women are three times more likely than men to be affected.

3.Ankylosing Spondylitis

the exact cause is unknown. A higher than expected level of HLA-B27 tissue antigen is seen in 90% of individuals with the disease. It is three to four

reduced joint motion, tenderness, crepitus, grating sensation, flexion contractures, joint enlargement late symptoms: tenderness on palpation, pain with passive range of motion, increase in degree and duration of pain, joint deformity and subluxation. early symptoms: nonspecific symptoms of fatigue, malaise, low-grade fever, anorexia, weight loss. midcourse symptoms: tenderness, pain, and stiffness in affected joints (most often the fingers) that occurs in a bilateral, symmetric pattern and spreads to the wrists, elbows, knees, and ankles; diminished joint function; paresthesia; joint contractures and deformities. early symptoms: recurrent pain in the lower back or large peripheral joints; morning stiffness that is relieved by activity; stooped posture; limited motion of lumbar spine

English in Kinetotherapy. A practical English handbook times more common in men than in women, and onset typically occurs between 20 and 40 years of age.

4. Osteoporosis

Inadequate calcium intake, early menopause, sedentary life-style, a familial hystory of the disease, endocrine disorders, prolongued immobility

or limited range of motion in affected joints; fatigue; fever; anorexia; weight loss; diminished chest expansion; red, painful eyes. late symptoms: kyphosis, fixed flexion of hips, vertebral fractures, impotence, incontinence, diminished bladder and rectal sensation, angina, pericarditis, pulmonary fibrosis (rare). A dull, aching, constant pain

in

the

particularly and

the

chest;

spasm;

the

column

bones, back muscle spinal mass

diminishes,

dorsal

kyphosis and cervical lordosis leading

increase, to

multiple

compression

fractures

of the spine and a 5. Low Back Pain

Muscle sprain or strain, arthritis, a tumor, or a ruptured cartilage

reduction in height. The pain may be accompanied by muscle weakness or spasms. It may radiate down the

45

46

6. Tendinitis and Tenosynovitis

7.Amyotrophic Lateral Sclerosis

ADINA RĂDULESCU disk between vertebrae; poor posture, obesity, enlarged prostate gland, sagging abdominal muscles, sitting for prolonged periods of time, or excessive physical effort involving the back muscles. Repetitive movements, strain, or excessive, unaccustomed exercise; underlying systemic disease (rheumatoid arthritis, gout, sclerosis); middleaged and older adults and athletes or individuals with occupations requiring repetitive motion are at greatest risk. The etiology of amyotrophic lateral sclerosis (ALS) is unknown, but proposed explanations include genetics, metabolic disturbances, and

back of one or both legs, as in sciatica. It may be started or increased by coughing, sneezing, rising from a seated position, lifting, stretching, bending, or turning.

The involved tendons usually show visible swelling; the joint may be tender and hot to the touch; motion of the joint causes pain.

early symptoms: weakness, cramps in the hands and forearms. midcourse symptoms: fatigue; dyspnea; slurred speech; dysphagia; asymmetric spread of muscle weakness to the rest of

English in Kinetotherapy. A practical English handbook external agents.

47

the body; spasticity; fasciculations; hyperactive deep tendon and extensor plantar reflexes. late symptoms: paralysis of vocal cords; paralysis of chest muscles, necessitating ventilatory support.

►◄Pair work 7. Check if your deskmate has attentively read the chart by asking him/her questions like these: • •

What are the main causes of low back pain? What are the early symptoms in Amyotrophic Lateral Sclerosis? • What are the late symptoms in Ankylosing Spondylitis? • The symptom of which disease is the visible swelling of tendons? • Which parts of the body are affected by pain in Ankylosing Spondylitis? • In which diseases does stiffness affect various parts of the body? Take turns in asking and answering various questions. 8. Extract or create sentences using the chart above and ask your deskmate to say if they are true or false. Example: Athlets or individuals with occupations requiring repetitive movements are very likely to suffer from Tendinitis and Tenosynovitis. → True

48

ADINA RĂDULESCU

Men are three times more likely than women to be affected by Rheumatoid Arthritis. → False 9. Translate the content of the chart above using a medical dictionary. 10. Match the disorders in the first column with their corresponding therapeutic exercises in the second column. Check the symptoms in the chart above so as to make the appropriate choice of the therapeutic exercises: The disorder 1. Osteoarthritis

2. Rheumatoid Arthritis

3.Ankylosing Spondylitis 4. Osteoporosis 5. Low Back Pain

Therapeutic exercises a. Therapy and exercise to increase range of motion, strength, and endurance; balance of activity and rest; splints, canes, walkers to aid mobility; moist compresses, paraffin gloves to reduce pain and edema. b. The patient should sleep on a firm mattress with the knees flexed and supported. Pain killers, muscle relaxants, and tranquilizers may help, as may applying dry or moist heat. When the pain subsides, the patient may increase activity if fatigue is avoided. A corset or back brace may be required. The patient should use a straight-backed chair and not cross or extend the legs. c. Moist heat compresses to joint; rest of joint with controlled progressive exercise program. d. Physical therapy, exercise, postural training; traction/back brace in special cases. e. Physical therapy to maintain muscle

English in Kinetotherapy. A practical English handbook

6. Tendinitis Tenosynovitis

and

7. Amyotrophic Lateral Sclerosis

49

strength; occupational therapy for activity of daily living support; speech therapy to aid communication; splints for neutral joint alignment; leg braces, canes, walkers to aid ambulation. f. Exercise: isometric, isotonic, isokinetic, strengthening, stretching, range of motion, balance exercise; rest; massage, moist heat for pain; elastic bandages for support; canes, walkers to aid mobility. Avoid: soft chairs, recliners, pillows under knees; use firm bed and hard chairs; wear sturdy, lowheeled shoes. g. Consistent exercise regimen, including weight-bearing hyperextension and resistance exercises to slow calcium loss and strengthen musculature; heat and massage for muscle spasm; orthopedic supports for back and neck to prevent stress fractures.

►◄ Pair work 11. Consider yourself as a kinetotherapist and choose the best way to recommand the corresponding therapeutic exercises to your colleague - patient who may ask you many questions regarding the duration, the difficulty and the expected results of such an exercise programme. Use the charts with medical information, symptoms and treatments above. Here are some examples to help you: Example: Therapist`s recommandations: • Considering your aggravated joint pain and your stiffness

ADINA RĂDULESCU

50

• •

following inactivity, it is to your best interest that you should start these therapeutic exercises. I do not want to put any pressure on you, but I do believe that you should consider starting your physical therapy as soon as possible. Your low back pain now radiates down the back of both your legs. And as things are not getting better, you should really take some urgent measures and start your therapy.

Patient`s questions: • In what way will my general condition be improved after starting these therapeutic exercises? • How long will this therapy be and how many sessions a week are necessary? • Will this therapy be painful? How difficult are the exercises? • Do I have to make any changes in my diet or in my daily routine? • Will this short-term therapy prevent the disease from getting worse?

English in Kinetotherapy. A practical English handbook

51

UNIT 9 POSTURAL PROBLEMS CONDITIONAL CLAUSES THERAPIST-PATIENT DISCOURSE COMMUNICATION

–

IMPROVING

1. Read the following text, consult the glossary below and translate the text into Romanian: POSTURAL PROBLEMS “Posture is a position or attitude of the body, the relative arrangement of body parts for a specific activity, or a characteristic manner of bearing one`s body. A postural fault is a posture that deviates from normal alignment but has no structural limitations. The postural pain symdrome refers to the pain that occurs from mechanical stress when a person maintains a faulty posture for a prolongued period; the pain is usually relieved with activity. There are no abnormalities in muscle strength or flexibility, but if the faulty posture continues, strength and flexibility imbalances will eventually develop. Lordotic posture This posture is characterized by an increase in the lumbosacral angle,

52

ADINA RĂDULESCU

an increase in the lumbar lordosis, and an increase in the anterior pelvic tilt and hip flexion. This is often seen with an increased thoracic kyphosis and forward head and is called a kypholordotic posture. Relaxed or slouched posture This posture is also called swayback. The entire pelvic segment is shifted anteriorly, resulting in hip extension and the thoracic segment is shifted posteriorly, resulting in flexion of the thorax on the upper lumbar spine. This results in an increased lordosis in the lower lumbar region, an increased kyphosis in the lower thoracic region, and usually a forward head. When standing for prolongued periods, the person usually assumes an asymmetric stance in which most of the weight is borne on one lower extremity, with periodic shifting of weight to the opposite extremity. Flat low-back posture This posture is characterized by a decreased lumbosacral angle, a decreased lumbar lordosis, hip extension, and a posterior tilting of the pelvis. Flat upper back posture This posture is characterized by a decrease in the thoracic curve, depressed scapulae, depressed clavicle, and a flat-neck posture. It is associated with an exaggerated military posture but is not a common postural deviation. It is not normal for a person to always maintain good posture. Therefore, the patient should be instructed to use cues throughout the day to check posture. For example, the patient can be instructed to check the posture every time he or she walks past a mirror, waits at a red light while driving a car, sits down for a meal, enters a room, or begins talking with someone. If the patient becomes aware of his/her daily routines, they can be used as reminders to practise maintaining a good posture.” (Carolyn Kisner&Lynn Allen Colby – Therapeutic Exercise. Foundations and Techniques)

English in Kinetotherapy. A practical English handbook

53

GLOSSARY

to bear one`s body = a-şi susţine corpul postural fault = defect postural mechanical stress = solicitare mecanică imbalance = dezechilibru eventually = în cele din urmă pelvic tilt = înclinare/aplecare pelviană forward head = cap împins către anterior to slouch = a se gârbovi. cocârja swayback = înclinare spre spate to shift = a deplasa, schimba stance = poziţie, postură bear, bore, borne = a purta, a duce flat low-back posture = postură aplatizată a zonei inferioare a spatelui flat upper-back posture = postură aplatizată a zonei superioare a spatelui thoracic curve = curbură toracică depressed scapulae = omoplaţi căzuţi, lăsaţi flat-neck = gât întins cues = indicii throughout the day = pe toată durata zilei 2. Check your reading comprehension by solving the following tasks: 1. After reading about the four faulty postures, try demonstrating each of them in front of the classroom. 2. Define in your own words what a postural fault is. 3. When does postural pain syndrome occur? 4. What happens if a patient continues to maintain a faulty posture? 5. What are the visible signs of kypholordotic posture? 6. What postural habit does the slouched patient manifest while

ADINA RĂDULESCU

54

7. 8. 9. 10.

standing? What are the characteristics of flat upper-back posture? What methods can a patient use to correct a faulty posture? What are the causes of faulty postures, in your opinion? How do you correct your faulty postures when you become aware of them?

■ GRAMMAR CONDITIONAL CLAUSES Conditional clauses consist of two parts: the subordinate clause or the if-clause and the main clause. There are three main types of conditional clauses and various mixed types. Each type is used to express different real/unreal, present/past conditions, using certain pairs of tenses. There are also many exceptions from each type but students dealing with conditionals for the first time should simply concentrate on the basic rules that will be presented in the following chart: Types

If-clause

Main clause

Type I

Present tense simple If the faulty posture continues,

Future tense simple strength imbalances will develop. Modal verbs

Present simple If the increases,

tense pain

Present tense simple If you get tired,

the patient must/should see a doctor. Imperative take a break and then start again.

Meaning Real situation, present or future oriented

English in Kinetotherapy. A practical English handbook Type II

Past tense simple/continuous

If I were you, If he had more time, If she did what the doctor says, TypeIII

Past perfect simple/continuous

If I had known anything about first help, If you had practised your therapeutic exercises,

would could + short should infinitive might I would try the new procedure. he could come to his sessions. she might have a chance to avoid surgery. would could + have + should past might participle I could have helped the injured cyclist. you would have felt better.

55

Unreal, hypothetic situation, present or future oriented, unlikely to happen Imaginary situation, past oriented (regrets, unfulfilled plans, wishes to change the past)

3. Fill in the gaps with the verbal constructions in the box to complete the following conditional clauses:

may simply disappear would not have felt had performed is

begins knew check

should get up cannot relax could control

1. If the patient ……………. to feel discomfort, ask him to corret the faulty posture. 2. If you were able to notice what posture causes your low back

56

ADINA RĂDULESCU

pain, you …………………… it. 3. If you modify your sleeping posture, your morning pains ……………………… . 4. If he ………………. his relaxation exercises, he would not have got stiff-necked. 5. If you are experiencing any pain, …………. posture. 6. If you have a sedentary job, you …………….. and walk every hour. 7. If the mattress …….. too soft, the patient sags and stresses ligaments. 8. If the mattress is too firm, some patients ………………. 9. If she had slept in a comfortable bed, she …………………….. so tired in the morning. 10. If I ………… what my ideal sleeping posture is, I would not hesitate to immediately adopt it. 4. Put the verbs in brackets into the correct tense: a) I met my wife in hospital ten years ago. I had fallen on ice and broken my leg. She was a nurse in my orthopaedics ward. Just imagine! If I (1)………….. (not fall) on ice and (2) ……………. (not brake) my leg, I (3) …………………. (never meet) her. So I could say that there is nothing so bad as not to be good for something. b) If this desk height (4) ………… (be) adequate, I (5) …………………. (not have to) lean over my work. My back is killing me! Not to mention the chair! If it (6) …….. (not be) so high, my feet (7) ……………. (rest) comfortably on the floor. I should complain about all these to our personnel manager. If more employees (8) ………….. (express) their complaints, some measures (9) ……………………. (passive –

English in Kinetotherapy. A practical English handbook

57

take).

c) You know what they say, that it all happens for a reason… Take my example. If (10) …………….. (passive – not be) injured in that car accident last year, I (11) …………… (accept) that job offer in Paris. But here I am now… working in this rehabilitation clinic… If people (12) ……… (know) how to deal with their disabilities, they (13) ……………. (be able) to accept them more easily. 5. Rewrite the following sentences, using an if construction: Example: a) The patient suffers from osteoporosis. Then, he will need physical therapy, exercise and postural training. If the patient suffers from osteoporosis, then he will need physical therapy, exercise and postural training. b) The patient did not sleep on a firm mattress. He had to take pain killers and muscle relaxants for his poor back. If the patient had slept on a firm mattres, he would not have had to take pain killers and muscle relaxants for his poor back. 1. This injury is severe. That is why the patient may run the risk of paralysis. 2. He got injured in a football match. He had his left leg broken. 3. I worked hard to finish my science project. I had mild low back pain for a week after. 4. My mother has a low resistance. She catches diseases very easily. 5. The old man got panic-striken. His heart started beating more rapidly.

58

ADINA RĂDULESCU

6. He has the surgery right now. The chances of success may increase to about 20%. 7. The infection spread. That is why he needed that urgent treatment. 8. The diagnosis is correct. The family will have to evaluate their options. 9. You do not spend enough time relaxing. That is why you are always complaing about being tired. 10. These therapeutic exercises are to be practised every day. They prevent the patient`s condition from getting worse. 6. Translate the following conditional sentences into English: 1. Dacă practici aceste exerciţii regulat, vei dobândi flexibilitatea şi rezistenţa necesare pentru menţinerea stabilităţii spinale. 2. Dacă vrei să-ţi uşurezi acestă durere acută, trebuie în primul rând să-ţi modifici obiceiurile posturale. 3. Nu poţi obţine stabilitate posturală dacă nu înveţi să-ţi controlezi greutatea corporală. 4. Dacă aş fi ştiut că oboseala musculară măreşte riscul de accidentare, nu m-aş mai fi antrenat atât de mult. 5. Dacă eşti obosit şi te simţi mult mai relaxat într-o poziţie gârbovită, corectează-ţi imediat această tendinţă nesănătoasă. 6. Dacă persistaţi în a vă menţine defectele posturale pentru mult timp, aceasta va duce la slăbire musculară şi la rezistenţă musculară redusă. 7. Dacă meseria vă solicită să staţi aplecaţi pentru perioade îndelungate de timp, nu uitaţi să faceţi o pauză scurtă din oră-n oră şi să vă faceţi

English in Kinetotherapy. A practical English handbook

59

exerciţiile de întindere. 8. Dacă pacienţii ar fi mai conştienţi de programul lor de mişcări sigure, nu le-ar mai fi teamă de o nouă accidentare. 9. Dacă un pacient cu handicap fizic vrea să fie independent, el va trebui să înveţe cum să-şi modifice mediul înconjurător: patul, scaunele, scaunul din maşină, locul de muncă etc. 10.Dacă pacienţii doresc ca programul lor de exerciţii să fie eficient, ar trebui să cunoasă mai întâi foarte bine tehnicile posturale şi numai apoi să le şi execute. ☼ THERAPIST-PATIENT DISCOURSE Improving communication 7. Insert the sentences below in their corresponding semantic class: A. THERAPIST`S INSTRUCTIONS B. CHECKING IF THE PATIENT GOT THE MESSAGE C. OFFERING ASSISTANCE FOR THE PATIENT D. ENCOURAGING THE PATIENT E. BUILDING MUTUAL TRUST F.GETTING A POST-PRACTISE FEED-BACK FROM THE PATIENT

Example: Do you see my point?→B.(CHECKING IF THE PATIENT GOT THE MESSAGE)

1. Lean backward and hold the stretch!

ADINA RĂDULESCU

60

2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30.

Did you get it right? Is this too difficult for you? I`m right here if you need me! Don`t worry! I`ll keep an eye on you! You can do it! Give it another try! Need I say this again? You have to trust me on this! Have the cramps gone away now? Lean forward, resting your abdomen on the anterior thighs. Does this make any sense to you? Don`t hesitate to ask for my help! You had to deal with worse than this before! Can you manage practising this exercise by yourself now? You have to take my word for it! Are you with me on this? Don`t give up! One more try! Have you experienced any muscle spasms during this exercise? Bend your trunk laterally and hold the position. Did you take my hint? If you need a helping hand… I`m not going anywhere! Do your best! It`s worth trying! Does it still hurt when you flex your knee? You will have to learn to trust me. Tuck in your chin and lift your head. Did you get my message? Do you still feel pins and needles in your feet? I give you my word on this! Don`t you doubt it! Lift both arms simultaneously. Are your fingers still numb now?

8. Create your own therapist-patient dialogues using the semantic classes above and the examples provided for each class. Follow the logical order of asking questions (first the instructions, then the

English in Kinetotherapy. A practical English handbook

61

checking part and so on so forth). 9. Read the following types of dialogues and match them with their corresponding titles: 1. 2. 3. 4. 5. 6.

Fixing an appointment Changing an apointment Returning a call Taking a family history Taking a social history Examining a patient

A. Dr. Thomson: Well, are you married? Mr. Stiff: Yes, of course, who isn`t ? Dr. Thomson: Do you have any children? Mr.Stiff: Yes, but they are no longer living with us. Dr. Thomson: What about your parents? Are they in good health? Mr. Stiff: My mother died last year. Bone cancer. And my father suffers from osteoarthritis. Dr. Thomson: I`m sorry to hear that. B. Secretary: Wilkinson Rehabilitation Centre. Hello, may I help you? Mr. Jones: Yes, hello. I am calling to fix an appointment, to see Dr. Wilkinson. Secretary: Right. Let me check his schedule. Er… how about 25th of September? Mr. Jones: Oh, I `m afraid it is a bit late. I have an urgent matter, you see… Secretary: Well, what about 21st of September, at 11 a.m.? Mr. Jones: Oh, that`s better, thank you. Secretary: Call us, please, in case you can`t make it. Mr. Jones: Thank you, it would not be the case.

62

ADINA RĂDULESCU

C. Dr. Richards: Could you just take off your clothes so that I can examine you? Mr. Spike: Okay, I have done this many times… Dr. Richards: Would you, please, lie flat on the couch for a few minutes? Can you now show me where it hurts? Mr. Spike: Right here, in my left thigh. Dr. Richards: Can you raise your left leg for me? And hold it for a second? Does it hurt when you rotate it? Mr. Spike: A little bit, when I return to the initial position. D. Mrs. Slender: Hello, Dr. Walsh? Dr. Walsh: Speaking. Mrs. Slender: Ah, Mrs. Slender here. Dr. Walsh: Yes, hello, Mrs. Slender. It is good that you returned my call. Mrs. Slender: Is there anything wrong, doctor? Dr. Walsh: No, nothing to worry about. I have just received your Xrays and it looks that your ankle is not broken, but just sprained. Mrs. Slender: Oh, what a relief! Dr. Walsh: Please, come to see me tomorrow and we`ll discuss more about it.

E. Secretary: Wilkinson Rehabilitation Centre. Hello, may I help you? Mr. Jones: Yes, hello. I`m Jones, I called you a couple of days ago… Secretary: Yes, Mr. Jones. What can I do for you? Mr. Jones: It is about my appointment. I won`t be able to make it. I wonder if we could possibly move it to the 25th of September? Secretary: First of all, Mr. Jones, you change your appointment at

English in Kinetotherapy. A practical English handbook

63

short notice and then you want to fix the day for your future appointment? Mr. Jones: I`m very sorry if I have cause you any inconvenience. Shall I call back another time? Secretary: We have your phone number and if someone cancels an appointment we`ll let you know. Mr. Jones: Thank you for your trouble. F. Dr. Thomson: Yes, you are still working, isn`t it? Mr. Stiff: Yes, two more years till my retirement. Dr. Thomson: Have you pushed yourself too hard lately? Mr. Stiff: You know how things are. I am no longer young and keeping up with the newly hired …… Dr. Thomson: What about your working hours? Have you considered working part-time? Mr. Stiff: I`m afraid this is not an option in my field. Dr. Thomson: Then, I hate to bring you the bad news, but you should consider retiring…. Otherwise….. ►◄ Pair work 10. Create your own dialogues, starting from the following titles: Introductory dialogues, The first examination, Programming the first session, Recommending a better treatment, Proposing a new experimental programme, Explaining how the devices work, How to focus your effort, Dealing with home exercises programme, etc.

ADINA RĂDULESCU

64

UNIT 10 REVISION EXERCISES 1. Complete the following sentences using the nouns in the box:

dislocation cartilage balance postural fault

muscular dystrophy fracture spinal column joints cardiovascular disease range of motion exercise

English in Kinetotherapy. A practical English handbook

65

1. The ……………….. is made up of 33 vertebrae that are separated by spongy disks and protects the spinal cord that runs inside of it among other things. 2. The connections between bones are called ………… each being classified according to structure and movability as fibrous, cartilaginous, or synovial. 3. The ……………….. is a tissue made of cells and fibers, that connects and supports. It is found mostly in the joints, the chest, and stiff tubes of all sorts, as the voicebox (larynx), windpipe (trachea), nose, and ear. 4. In all forms of …………………… there is a slow loss of strength with increasing disability and deformity. 5. ……………… is the displacement of any part of the body from its normal position; this applies most often to a bone moved from its normal position with a joint. 6. A ……………… is an injury to a bone in which the tissue of the bone is broken. 7. A ………………………….. may cause problems with the heart and blood vessels. 8. ……………….. refers to the ability to maintain the center of gravity over the base of support, usually while in an upright position. 9. ……………………….. any body action involving the muscles, joints, and movements in natural directions of arms and legs. 10. A …………………… is a posture that deviates from normal alignment but has no structural limitations. 2. Choose the right version that best completes the sentence: 1. Being placed in a supine position means: a) lying flat or face downwards;

ADINA RĂDULESCU

66

2.

3.

4.

5.

6.

b) lying or resting on the back, with the face, palm, etc upwards; c) sitting cross-legged; d) side-lying, with one arm up. To adduct the arm means: a) to draw or pull the arm towards the median axis of the body; b) to flex and elongate the arm successively; c) to pull away the arm from the median axis of the body; d) to turn the arm around its own axis. ………………….. is a generalized, progressive reduction of bone mass as bone resorption outstrips bone formation, causing skeletal weakness and fractures. a) Osteomyelitis; b) Osteoarthritis; c) Rheumatoid Arthritis; d) Osteoporosis. Inadequate calcium intake, early menopause, sedentary lifestyle, endocrine disorders, prolongued immobility are some of the causes of …………….. a) Osteoarthritis; b) Ankylosing Spondylitis; c) Osteoporosis; d) Amyotrophic Lateral Sclerosis. An abnormal, increased degree of forward curvature of any part of the spine is the characteristic of ……………. a) kypholordotic posture; b) lordotic posture; c) slouched posture; d) flat low-back posture. …………………………. are necessary to treat joint dysfunctions such as stiffness, reversible joint hypomobility, or pain. a) strenghtening exercises;

English in Kinetotherapy. A practical English handbook

67

b) stretching exercises; c) weight-bearing exercises; d) joint mobilization exercises. 7. ……………………………… is the ability of a muscle to contract repeatedly or generate tension, sustain that tension and resist fatigue over a prolonged period of time. a) muscle strength ; b) muscular endurance ; c) muscular contraction ; d) mulcular extensibility. 3. Find the root-verbs that the following nouns are derived from: examination, treatment, assessment, decision, diagnostician, information, retirement, development, selection, questioning, interpretation, palpation Example: examination ← examine (the root-verb) 4. Derive the corresponding nouns, adjectives and adverbs from the following verbs: affect, aggravate, compress, contract, diminish, disturb, explain, expect, function, immobilize, include, increase, limit, paralyse, propose, radiate, reduce, repeat, suspect, swell. Example: verb repeat

noun repetition, repeater,

adjective repeatable, repeated, repeating, repetitional

adverb repeatedly

5. Find the corresponding stress-emphasis pattern for the

68

ADINA RĂDULESCU

following two/three/four/multi-syllable words and pronounce them accordingly: affected, aggravated, alignment, compression, contracture, deformity, disease, duration, fasciculation, hyperextension, inactivity, kypolordotic, lumbosacral, pericarditis, recliner, strengthening, stiffness, subluxation, tranquilizer.

6. Complete each space with a word formed from the words in capitals. A. Warming up soft tissues prior to stretching will increase the (1) …………… of the shortened tissue. Warm muscles relax and (2)……………. more easily, making stretching more (3) ………………….. for the patient. As the temperature of muscle increases, the amount of force required to elongate noncontractile and contractile tissues and the time the stretch force must be (4) ………………. decrease. Although stretching is often thought of as a warmup activity and performed prior to (5) …………… exercise, the clinician and patient must always remember that an appropriate warm-up must also occur in the (6) ………………….. for stretching. It is (7) ………………… whether heating should occur prior to or during the stretching procedure.

EXTEND LENGTH COMFORT

APPLY

VIGOUR

PREPARE DEBATE

English in Kinetotherapy. A practical English handbook

B. Some anger may serve a (1) ………… purpose; much anger however, is purely (2)……………….. The energy that goes into its arousal could often be more (3) ……………….. spent in solving the problem. Here are some ways in which anger can be controlled: • reinterpreting the stimulus in a more positive light; many situations contain ambiguities which allow (4) ……………….. to be made; • being realistic in our (5)………………. of other people; • giving oneself (6)……………… to make a mistake, as it is part of being human to make mistakes (7)…………….. • distancing oneself; if circumstances seem to be overwhelming, one can try stepping back mentally to get a more (8) …………………. view; • introducing humour at (9)………….. moments; when a person smiles and laughs the (10) ……………. response takes over.

69

USE DESTRUCT PROFIT

REINTERPRET EXPECT PERMIT OCCASION

OBJECT SUIT RELAX

7. Read the text below and choose the version that best completes the empty spaces: Pain is often the reason why the patient has come for attention in the first place. Always remember that pain is a/an (1) …………….. to the patient who may find that it is making his or her life (2)…………… . Pain is a/an (3)………….. experience and any measurement must

70

ADINA RĂDULESCU

incorporate a degree of (4) ………………. . Reactions to pain vary widely (5) …………. different people and depend (6) ……. many different physical and mental factors. Specific diseases and injuries and the health, pain (7) …………., fear and anxiety, and ethnic background all affect reactions to pain. Patients will describe pain (8) ……….. in terms of its sensory qualities, for example shooting, sharp, burning or in terms of its affective qualities, for example vicious, cruel, sickening, or in terms of its evaluative qualities, for example intense, unbearable, annoying. Severe pain causes pale skin, cold sweat, "(9)…….. bumps," wide pupils, and higher levels of pulse, breathing rate, blood (10) ……….., and muscle (11)………… . When brief, strong pain starts to go away, the pulse may be slower and the blood pressure lower than before the pain began. If pain occurs often or is long term, the pulse (12) ……. and blood pressure may not go up much. If pain lasts for many days, the (13) ………… to fight infections may be lost. The patient's tone of voice, speed of speech, cries, groans, or other sounds, face and body movements, or attempts to withdraw are noted by the physician. It is hard to (14) ………… strong or long-term pain, but a patient can learn to live almost (15) ………….. even with some pain. 1. a) illusion 2. a) intolerable 3. a) individual 4. a) objectivity 5. a) to 6. a) on 7. a) point 8. a) or 9. a) hen 10. a) group 11.a) bulk 12. a) rate 13. a) talent

b) reality b) impossible b) objective b) doubt b) among b) of b) limit b) either b) road b) relation b) tension b) rhythm b) volition

c) dream d) perception c) easier d) irritating c) personal d) subjective c) subjectivity d) error c) with d) from c) in d) with c) degree d) level c) neither d) nor c) goose d) heat c) test d) pressure c) spasm d) strain c) beat d) tempo c) ability d) capacity

English in Kinetotherapy. A practical English handbook

71

14. a) relieve b) cure c) release d) solace 15. a) usually b) patiently c) regularly d) normally 8. Turn the following sentences from active voice into passive voice. Begin the passive sentences with the underlined words: 1. Total body streching, such as toe touches, may maintain or overstretch a mobile area. 2. Strengthening programs tend to overemphasize flexion exercises. 3. When performing this kind of stretch, you must keep your shoes on. 4. Patients should perform flexibility exercises prior to and after a strengthening program. 5. An effective stretching or flexibility routine should not cause pain or excessive stress to tissues. 6. Patients should slightly bend their knees when performing forward-bending exercises. 7. You will warm up the tissues with gentle rhythmic activities. 8. Increase the pace of activity so that you can maintain the target heart rate for 10 to 20 minutes. 9. To avoid injuries from stress, you should use appropriate equipment, such as correct footware. 10. People often use inappropriately the phrase “No pain, no gain” as the guideline for intensity of stretch. 9. Identify the type of the following conditional sentences and fill in the missing tenses or modal constructions to complete them: 1. If pain begins while exercising, you ………………… (decrease) effort and rest between sessions. 2. You would have avoided overuse symdromes if you ………………… (perform) proper warm-up. 3. If she really wanted to protect vulnerable joints, she …………………... (not stress) joints and ligaments at the end

72

ADINA RĂDULESCU

of the range. 4. If he wanted to increase his muscular endurance, he ……………………. (perform) the exercises with many repetitions and minimal resistance to the point of muscle fatigue. 5. If you ………….. (keep) your knee straight, the gastrocnemius is stretched. 6. If you do not want to be injured during your aerobic program, you …………… (avoid) running, jogging or aerobic dancing on hard surfaces such as asphalt and concrete. 7. If your sister had practised aerobic activity 3 to 5 times per week, she …………………. (feel) much better. 8. If you bend your knee, the soleus ………. (be) stretched. 9. Concentrate on stretching the tight muscles, if there …… (be) decreased flexibility between antagonistic muscle groups. 10. If your patient were excessively mobile in a segment of his body, it ………………… (be) safer to selectively stretch tight structures than the total body. 10. Translate intoRomanian, without using a dictionary: a) Inability to reverse the normal lumbar lordosis on flexion occurs in degenerative arthritis. Limited lumbar flexion is characteristic of ankylosing spondylitis. Localized bone pain suggests such disorders such as osteomyelitis, leukemia, primary or metastatic cancer, compression fracture or herniated disk. b) Normally, when a patient had limited range of motion, the therapeutic approach was to stretch the region with passive stretching techniques. Over the past 30 years, therapists have identified and learned techniques that deal more directly with stretching the source of limitation, and thus they are managing dysfunctions better and with less trauma. Muscle elongation or active inhibition techniques are used to counteract the loss of flexibility in the contractile elements of

English in Kinetotherapy. A practical English handbook

73

muscles; cross-fiber massage techniques are used to increase mobility in selected ligaments and tendons; and joint mobilization and manipulation techniques are used to safely stretch or snap structures to restore normal joint mechanics with less trauma than passive stretching. c) It could be argued that smoking has more to do with relaxation than smoking abstinence has, and many people become smokers because they perceive cigarettes as being a source of mental calm. However, many such people then wish to quit smoking. Quitting is associated with stress, which means that the same people may be seeking relaxation training. Health care professional increasingly find themselves faced with groups of people who are struggling to give up cigarettes and for whom relaxation training hes been prescribed. 11. Translate into English: a) Staţi întinşi sau aşezaţi într-o poziţie pe care o simţiţi comodă. Închideţi ochii. Simţiţi cum începeţi să vă relaxaţi. Pe măsură ce trupul şi mintea se calmează, permiteţi-i locului dumneavoastră special să ia contur în imaginaţia dumneavoastră. Observaţi priveliştea, sunetele şi mirosurile acestui loc. Apoi, încercaţi să simţiţi cum muşchii se relaxează, eliminând tensiunea de peste zi. b) Staţi aşezaţi, cu tălpile unite către interior şi cu genunchii îndreptaţi lateral către exterior. Plasaţi-vă mâinile în jurul gleznelor şi odihniţi-vă coatele pe coapse. Apăsaţi uşor cu coatele asupra coapselor. Apoi odihniţi-vă. Apăsaţi apoi din nou. Ar trebui să simţiţi o întindere plăcută în zona şoldului. c) Pentru a învăţa să conduceţi relaxaţi, în primul rând

74

ADINA RĂDULESCU

identificaţi grupele musculare de care aveţi nevoie pentru condus. Dacă observaţi că aceste grupe sunt tensionate, relaxaţi-le. Verificaţi dacă şi muşchii pe care nu-i solicitaţi când conduceţi, cum ar fi muşchii feţei, sunt relaxaţi. Nu uitaţi zona umerilor. Menţineţi-vă relaxaţi şi atunci când viraţi sau schimbaţi viteza. d) Exerciţiile de întindere sunt atât de utile pentru că ajută la menţinerea elasticităţii. Elasticitatea este una dintre proprietăţile ţesutului muscular care nu numai că permite muşchilor să funcţioneze mai bine, dar îi şi protejează faţă de o posibliă accidentare. De multe ori, obişnuim la modul inconştient să ne întindem, după ce am stat mult timp în aceeaşi poziţie. Se pare că trupul nostru ne-o cere. Ne întindem după ce dormim, după ce stăm cu orele la birou, după ce lucrăm aplecaţi în grădină…

GLOSSARY spine/spinal column/backbone = vertebra, -ae/bony ring = spinal cord/marrow = rib = articular cartilage = sternum/breastbone = thoracic cage = shoulder girdle =

coloana vertebrală vertebră măduva spinării coastă cartilaj articular stern cuşcă toracică centură scapulară

English in Kinetotherapy. A practical English handbook

scapula/shoulder blade = clavicle/collarbone = sacrum = coccyx = articulation/joint = fibrous joint = synovial joint = hip joint = knee joint = ankle joint = cranium/skull = tissue = connective tissue = calcaneus/heel = limb = nostril = thyroid cartilage/Adam`s apple = nape (of the neck) = axilla/armpit = carpus/wrist = knuckle = hip = thigh = calf, calves = shin/cannon bone = patella, -ae/knee cap = instep = sole = bowels = diaphysis = epiphysis = epiphyseal cartilage = blood vessels = muscle bulk = muscular contraction /cramp =

omoplat, scapulă claviculă os sacral coccis articulaţie articulaţie fibroasă articulaţie sinovială articulaţia şoldului articulaţia genunchiului articulaţia gleznei craniu ţesut ţesut conjunctiv călcâi membru nară cartilaj tiroidian ceafă axilă, subsuoară încheietura mâinii articulaţia degetului şold coapsă gambă, -e tibia, fluierul piciorului rotulă scobitura gleznei talpă intestine diafiză epifiză cartilaj epifizar vase sanguine masă musculară contracţie musculară

75

76

ADINA RĂDULESCU

muscular endurance = muscle fatigue = muscular hypertrophy = muscle tone = hypotonic muscles = hypertonic muscles = muscle rigidity = muscle spasm = spasticity = muscle sprain = muscle strain = muscle strength = muscular tension = muscular weakness = hypokinesia = hyperkinesia = stasis = muscular dystrophy = electromyography = cartilage disk = arthritis = medical history = medical examination sheet = testing devices = tape measure = goniometer = reflex hammer = cotton wool = test tube = gait = mien =

rezistenţă musculară oboseală/extenuare musculară hipertrofie musculară tonus muscular muşchi hipotonici muşchi hipertonici rigiditate musculară spasm muscular spasticitate luxaţie întindere musculară forţă musculară tensiune musculară slăbire musculară hipokinezie hiperkinezie stază distrofie musculară electromiografie disc cartilaginos artrită anamneză foaie de observaţie clinică instrumente de testare ruletă, panglică de măsurat goniometru ciocănel pentru testarea reflexelor vată eprubetă umblet, mers ţinută, comportament

English in Kinetotherapy. A practical English handbook

atelă orteză exerciţiu de susţinere a greutăţii corporale range of motion = grad de mobilitate exerciţii de întărire strengthening exercises = musculară avascular necrosis = necroză avasculară skeletal injury = leziune a sistemului scheletic umflătură swelling = rupture = ruptură, hernie sterile dressing = pansament steril anesthetic = anestezic contuzie, vânătaie contusion/bruise = tenosynovitis/inflamed tendons = tenosinovită arteriosclerosis/hardening of the arteroscleroză arteries = sedative/sleeping pill/dope = sedativ analgesic/pain killer = analgezic. calmant myocardial infarction/heart infarct miocardic attack = halitosis/bad breath = halitoză alopecia/baldness = alopecie tachycardia/palpitations = tahicardie hypoglycaemia/low blood sugar hipoglicemie = hyperglycaemia/ high blood hiperglicemie sugar = ankylosing spondylitis/bamboo spondilită anchilozantă spine = sprain one`s ankle/wrist= a-şi luxa glezna/încheietura mâinii strain one`s muscle = a suferi o întindere musculară a-şi întinde un tendon pull one`s hamstring muscle = splint = brace = weight-bearing exercise =

77

78

tear/pull a ligament = snap a tendon = chilblain/frostbite = cardiovascular fitness = plaster bandage = plaster cast = sticking plaster =

ADINA RĂDULESCU

muscular a suferi o ruptură ligamentară a suferi o ruptură de tendon degerătură tonus cardiovascular pansament gipsat formă/matriţă de gips leucoplast

English in Kinetotherapy. A practical English handbook

79

80

ADINA RĂDULESCU

English in Kinetotherapy. A practical English handbook

81

82

ADINA RĂDULESCU

English in Kinetotherapy. A practical English handbook

83

84

ADINA RĂDULESCU

English in Kinetotherapy. A practical English handbook

85

BIBLIOGRAPHY Buschbacher, R. M., Randall, L. B. Musculoskeletal Disorders. Diagnosis Butterworth –Heinemann, 2002.

Practical Guide to and Rehabilitation,

86

ADINA RĂDULESCU

Cobuild, C. - English Guides. Word Formation, Haeper Collins Publishers, 1991. Donatelli, R. and Owens-Burkhart, H. - Effects of immobilization on the extensibility of periarticular connective tissue. Journal of Orthopaedic and Sports Physical Therapy, 1981. Garrison, S. J. - Handbook of Physical Medicine and Rehabilitation Basics, J. B. Lippincott Company, 1995. Gray, H. - Anatomy. Descriptive and Surgical, London, the Promotional Reprint Company Ltd.,1991. Hollis, M. and Yung, P. - Patient Examination and Assessment for Therapists, Blackwell Scientific Publications, first published 1985. Holme, R. - ESP ideas. Recipes for teaching professional and academic English, Longman, first published 1996. Howley, E. T. and Franks, B. D. - Health/Fitness Instructors Handbook. Human Kinetics, Champaign, I. L., 1986. Hutchinson, T. and Waters, A. - English for Specific Purposes, Cambridge University Press, first published 1987. Kisner, C. and Colby, L. A. - Therapeutic Exercise. Foundations and Techniques, Philadelphia, F. A. Davis Company, 1996. Maher, J. C. - International Medical Communication in English, Edinburgh University Press, Edinburgh, 1990. McCarthy, M. - Vocabulary, Oxford University Press, first published 1990. Oxford Advanced Learner`s Encyclopedic Dictionary, Oxford:Oxford University Press, first published 1989. Pârlog, H. - English Phonetics and Phonology, Ed. ALL, Bucureşti, 1997. Payne, R. A. - Relaxation Techniques. A Practical Handbook for the Health Care Profesional, Churchill Livingstone, New York, 1995 Quirk, R., Greenbaum, S., Leech, G., Svartvik, J. - A Comprehensive Grammar of the English Language, Longman, 1985. Randall, L. B. - Physical Medicine and Rehabilitation, second edition, W. B. Saunders Company, 2000. Riley, D. - Check Your Vocabulary for Medicine. A Workbook for

English in Kinetotherapy. A practical English handbook

87

Users, Peter Collin Publishing. Sinelnikov, R. D. - Atlas of Human Anatomy, vol.1 – The Science of Bones, Joints, Ligaments and Muscles, MIR Publishers, Moscow, first published 1988. The Merk Manual of Diagnosis and Therapy, Sixteenth Edition, Merk Research Laboratories, U. S. A., 1992. The Oxford-Duden Pictorial English Dictionary. Science and Medicine, Oxford University Press., Thomson, A.J. and Martinet, A.V. - A Practical English Grammar, Oxford University Press, 1986. Zaharia, C. - Elemente de patologie a aparatului locomotor, Ed. Paideia, Bucureşti, 1994.